Accidental deep hypothermia with cardiac arrest. Prompt complete recovery after rewarming by extracorporeal circulation. Case report.
BACKGROUND
Deep accidental hypothermia (core temperature <28 degrees C) is an uncommon medical emergency requiring rapid active core rewarming. Extracorporeal circulation has become the treatment of choice for deep hypothermic patients with cardiac arrest.


METHODS
We report on a 30-year-old patient who suffered from deep accidental hypothermia (core temperature 24.8 degrees C) and cardiac arrest by prolonged exposure to a cold urban environment as a consequence of severe ethylalcohol intoxication. The rewarming with the aid of extracorporeal circulation was initiated shortly after his arrival at the hospital. External cardiac massage was maintained until full ECC fl ow was established. The patient was weaned from extracorporeal circulation after 157 min, awaked 4 hours later and consequently extubated within 16 hours after rewarming with no neurological impairment. At 3-week follow-up, the patient was fully re-integrated in his work and personal life.


CONCLUSIONS
This case demonstrates the excellent prognosis of a young victim in the case of deep accidental hypothermia with cardiac arrest, provided that deep hypothermia precedes the cardiac arrest and rewarming by extracorporeal circulation is immediately applied. Simultaneous ethyl alcohol intoxication can be considered a protective factor improving the patient's outcome. Complete recovery was achieved within 24 hours after the accident.
Simek
Martin
M
Department of Cardiac Surgery, University Hospital and Faculty of Medicine and Dentistry Palacky University, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic. martin.simek@c-mail.cz
Hajek
Roman
R
Bruk
Vilem
V
Fabikova
Karolina
K
Nemec
Petr
P
Raimr
Jakub
J
Husar
Roman
R
Hubacek
Petr
P
D000328:Adult; D005112:Extracorporeal Circulation; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy; D006801:Humans; D007035:Hypothermia / Q000150:complications / Q000628:therapy*; D008297:Male; D017694:Rewarming