title: Therapeutic peritoneal lavage with warm saline solution as an option for a critical hypothermic trauma patient.
abstract: BACKGROUND
  In this paper, we present the case of a 63-year-old woman, who was found in her flat lying unconscious on the floor for an unknown time. At the time of admission, her core temperature was 24 °C and ventricular fibrillation was detected on the electrocardiogram (ECG). Because of the unstable conditions, the persistent nonperfusing cardiac rhythm and the dramatically inhibited coagulation cascade, a peritoneal lavage connected to a rapid infuser was performed for rewarming, instead of using a transportable heart-lung machine and a haemodialysis device. After a prolonged cardiopulmonary resuscitation (CPR), the patient could be transferred to the intensive care unit (ICU) in a stable condition. After 40 days in the ICU, recovery was fast, and another month of treatment later, she could be discharged back home without any discomfort.
  
  
  CONCLUSIONS
  This report illustrates the successful use of the peritoneal lavage for rewarming a severely hypothermic patient without any extracorporeal rewarming device. Furthermore, it can be used in nearly every hospital if the necessary equipment is affordable. It is demonstrated that this technique is able to provide good outcomes for all victims of accidental hypothermia.
authors.affiliation: Department of Traumatology, Eberhard Karls Universität Tübingen, Schnarrenbergstrasse 95, 72076, Tübingen, Germany, thomas.freude@gmx.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Freude
authors.forename: Sonja
authors.initials: S
authors.lastname: Gillen
authors.forename: Sabrina
authors.initials: S
authors.lastname: Ehnert
authors.forename: Andreas
authors.initials: A
authors.lastname: Nüssler
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stöckle
authors.forename: Natascha
authors.initials: N
authors.lastname: Charalambakis
authors.forename: Stefan
authors.initials: S
authors.lastname: Döbele
authors.forename: Stefan
authors.initials: S
authors.lastname: Pscherer
mesh_terms: D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007035:Hypothermia / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications / Q000628:therapy*; D010533:Peritoneal Lavage / Q000379:methods*; D017694:Rewarming / Q000379:methods*; D012965:Sodium Chloride / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D012965:Sodium Chloride