[Rewarming of patients with accidental hypothermia with the help of heart-lung machine].
BACKGROUND
Different techniques have been used for treatment of victims with accidental hypothermia. We have used cardiopulmonary bypass (CPB) for rewarming hypothermic patients with circulatory failure or cardiac arrest. This report summarises our experiences with this patient group.


METHODS
23 patients, submersions (n = 15), avalanche (n = 1) and primary hypothermia (immersion/air cooling) (n = 7), were rewarmed using extracorporeal circulation with standard equipment for open-heart surgery.


RESULTS
On a clinical basis, two patient populations could be identified; one group for whom asphyxia was probably present prior to and during cooling, and another group for whom asphyxia was unlikely. In the first group, one of 13 patients survived compared to the latter group where six out of ten survived. A search for laboratory and other variables that with certainty could contribute to the prediction of prognosis was unsuccessful.


CONCLUSIONS
Due to lack of safe prognostic predictors, all accidental hypothermic victims with circulatory failure should be rewarmed by cardiopulmonary bypass before further therapeutic decisions are made.
Kirurgisk institutt/Universitetet i Bergen.
K
K
Farbrot
P
P
Husby
K S
KS
Andersen
K
K
Grong
M
M
Farstad
M E
ME
Koller
D000059:Accidents; D000293:Adolescent; D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D004630:Emergencies; D005112:Extracorporeal Circulation; D005260:Female; D006355:Heart-Lung Machine; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017694:Rewarming / Q000379:methods*