Open AccessExtracorporeal Life Support in Accidental Hypothermia with Cardiac Arrest—A Narrative Review
Author(s) -
Justyna Swol,
Tomasz Darocha,
Peter Paal,
Hermann Brugger,
Paweł Podsiadło,
Sylweriusz Kosiński,
Mateusz Puślecki,
Marcin Ligowski,
Mathieu Pasquier
Publication year - 2021
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.961
H-Index - 66
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000001518
Subject(s) - medicine , asystole , hypothermia , accidental hypothermia , clinical death , pathophysiology , cardiopulmonary resuscitation , intensive care medicine , life support , pulmonary edema , extracorporeal , anesthesia , resuscitation , cardiology , lung
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.