title: Treatment of severe accidental hypothermia with intermittent hemodialysis.
abstract: The optimal management of moderate-to-severe hypothermia with hemodynamic instability remains unclear. Although cardiopulmonary bypass offers the most rapid rate of rewarming and has been suggested as the method of choice in the presence of circulatory arrest, there is no evidence to support the use of this highly invasive technique over other rewarming modalities in the absence of circulatory collapse. We report the successful treatment of hemodynamically unstable hypothermia with conventional hemodialysis in a patient with normal renal function, after initial efforts of rewarming using conventional strategies had failed. This case report and review of the literature highlights the advantages and the challenges of using hemodialysis in this setting, and suggests a potential role for hemodialysis in the routine management of moderate-to-severe hypothermia in the absence of circulatory arrest.
authors.affiliation: Division of Nephrology, University of Western Ontario, London, Ontario, Canada.
authors.forename: Nabil
authors.initials: N
authors.lastname: Sultan
authors.forename: Karl D
authors.initials: KD
authors.lastname: Theakston
authors.forename: Ron
authors.initials: R
authors.lastname: Butler
authors.forename: Rita S
authors.initials: RS
authors.lastname: Suri
mesh_terms: D000059:Accidents; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D005500:Follow-Up Studies; D006703:Ill-Housed Persons; D006801:Humans; D007035:Hypothermia / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis / Q000379:methods*