title: "Nobody is dead until warm and dead": prolonged resuscitation is warranted in arrested hypothermic victims also in remote areas--a retrospective study from northern Norway.
abstract: Hypothermic cardiac arrest has high mortality and few known prognostic factors. We studied retrospectively 34 victims of accidental hypothermia with cardiac arrest admitted to The University Hospital of North Norway during 1985-2013 who were resuscitated and rewarmed by extracorporeal circulation. No patient survived prior to 1999, while nine out of 24 (37.5%) survived hypothermic cardiac arrest from 1999 to 2013. The lowest measured core temperature among survivors was 13.7°C; the longest time from cardiac arrest to return of spontaneous circulation was 6 h and 52 min. The only predictor of survival identified was lower blood potassium concentration in the nine survivors compared with the non-survivors. Submersion was not associated with reduced survival. Non-survivors consumed modest hospital resources. Most survivors had a favourable neurological outcome.
authors.affiliation: Faculty of Health Sciences, UiT The Arctic University of Norway, N-9038 Tromsø, Norway. Electronic address: jonashilmo@gmail.com.
authors.forename: Jonas
authors.initials: J
authors.lastname: Hilmo
authors.affiliation: Division of Surgical Medicine and Intensive Care, Clinic of Emergency Medical Services, University Hospital of North Norway, N-9038 Tromsø, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, N-9038 Tromsø, Norway; Clinic of Emergency Medical Services, University Hospital of North Norway, N-9038 Tromsø, Norway; Clinical Cardiovascular Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, N-9038 Tromsø
authors.forename: Torvind
authors.initials: T
authors.lastname: Naesheim
authors.affiliation: Department of Clinical Medicine, UiT The Arctic University of Norway, N-9038 Tromsø, Norway; Clinic of Emergency Medical Services, University Hospital of North Norway, N-9038 Tromsø, Norway; Anesthesia and Critical Care Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9038 Tromsø, Norway.
authors.forename: Mads
authors.initials: M
authors.lastname: Gilbert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003643:Death; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007035:Hypothermia / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009664:Norway; D012151:Resuscitation / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: Accidental hypothermia; Cardiac arrest; Extracorporeal rewarming; Hyperkalemia; Prehospital; Survival