TY - JOUR
T1 - Extracorporeal Life Support in Accidental Hypothermia with Cardiac Arrest-A Narrative Review
AU - Swol, Justyna
AU - Darocha, Tomasz
AU - Paal, Peter
AU - Brugger, Hermann
AU - Podsiadło, Paweł
AU - Kosiński, Sylweriusz
AU - Puślecki, Mateusz
AU - Ligowski, Marcin
AU - Pasquier, Mathieu
N1 - Lehr-KH Barmherzige Brüder: Paal: Department of Anesthesiology and Intensive Care Medicine, Hospitallers Brothers Hospital, Paracelsus Medical University, Salzburg, Austria;
Swol: Deparment of Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Medical University, Nuremberg, Germany
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Severely hypothermic patients, especially suffering cardiac arrest, require highly specialized treatment. The most common problems affecting the recognition and treatment seem to be awareness, logistics, and proper planning. In severe hypothermia, pathophysiologic changes occur in the cardiovascular system leading to dysrhythmias, decreased cardiac output, decreased central nervous system electrical activity, cold diuresis, and noncardiogenic pulmonary edema. Cardiac arrest, multiple organ dysfunction, and refractory vasoplegia are indicative of profound hypothermia. The aim of these narrative reviews is to describe the peculiar pathophysiology of patients suffering cardiac arrest from accidental hypothermia. We describe the good chances of neurologic recovery in certain circumstances, even in patients presenting with unwitnessed cardiac arrest, asystole, and the absence of bystander cardiopulmonary resuscitation. Guidance on patient selection, prognostication, and treatment, including extracorporeal life support, is given.
AB - Severely hypothermic patients, especially suffering cardiac arrest, require highly specialized treatment. The most common problems affecting the recognition and treatment seem to be awareness, logistics, and proper planning. In severe hypothermia, pathophysiologic changes occur in the cardiovascular system leading to dysrhythmias, decreased cardiac output, decreased central nervous system electrical activity, cold diuresis, and noncardiogenic pulmonary edema. Cardiac arrest, multiple organ dysfunction, and refractory vasoplegia are indicative of profound hypothermia. The aim of these narrative reviews is to describe the peculiar pathophysiology of patients suffering cardiac arrest from accidental hypothermia. We describe the good chances of neurologic recovery in certain circumstances, even in patients presenting with unwitnessed cardiac arrest, asystole, and the absence of bystander cardiopulmonary resuscitation. Guidance on patient selection, prognostication, and treatment, including extracorporeal life support, is given.
KW - RESUSCITATION COUNCIL GUIDELINES
KW - CARDIOPULMONARY-RESUSCITATION
KW - MEMBRANE-OXYGENATION
KW - CIRCULATORY ARREST
KW - CORE TEMPERATURE
KW - SURVIVAL
KW - MANAGEMENT
KW - SOCIETY
KW - ECMO
KW - TERMINATION
U2 - 10.1097/MAT.0000000000001518
DO - 10.1097/MAT.0000000000001518
M3 - Review article
C2 - 34261875
SN - 1058-2916
VL - 68
SP - 153
EP - 162
JO - ASAIO JOURNAL
JF - ASAIO JOURNAL
IS - 2
ER -