Book contents
- Frontmatter
- Contents
- Introduction
- 1 Hypothermia as a Disorder
- 2 Epidemiology and Estimating Preventable Deaths in Accidental Hypothermia
- 3 Facts and Myths about Hypothermia and its Treatment
- 4 Measurement of Patient's Body Temperature
- 5 Prehospital Management of Hypothermia
- 6 Thermal Insulation
- 7 Airway Management in Hypothermic Patients
- 8 ECG in Hypothermia
- 9 Hypothermia as a Reversible Cause of Cardiac Arrest
- 10 The Role and Tasks of Polish Medical Air Rescue
- 11 Trauma and Hypothermia
- 12 Prehospital Management of Avalanche Victims
- 13 Prehospital Rewarming in Hypothermia. Indications, Methods, Problems and Pitfalls
- 14 Coagulopathies in Hypothermic Patient
- 15 Changes of Pharmacokinetics and Pharmacodynamics of Medications in Hypothermic Patients
- 16 Extracorporeal Therapy in Patients in Severe Hypothermia
- 17 Vascular Access for Extracorporeal Circulation
- 18 Problems and Pitfalls of Qualification for Extracorporeal Treatment of Patients in Severe Hypothermia
- 19 Procedure of Extracorporeal Treatment of Hypothermic Patients
- 20 Recommendation of National Consultant in the Field on Emergency Medicine
- 21 Accidental Hypothermia: the Need for the International Hypothermia Registry
- 22 Qualification for Extracorporeal Rewarming Medical Report
21 - Accidental Hypothermia: the Need for the International Hypothermia Registry
Published online by Cambridge University Press: 03 January 2018
- Frontmatter
- Contents
- Introduction
- 1 Hypothermia as a Disorder
- 2 Epidemiology and Estimating Preventable Deaths in Accidental Hypothermia
- 3 Facts and Myths about Hypothermia and its Treatment
- 4 Measurement of Patient's Body Temperature
- 5 Prehospital Management of Hypothermia
- 6 Thermal Insulation
- 7 Airway Management in Hypothermic Patients
- 8 ECG in Hypothermia
- 9 Hypothermia as a Reversible Cause of Cardiac Arrest
- 10 The Role and Tasks of Polish Medical Air Rescue
- 11 Trauma and Hypothermia
- 12 Prehospital Management of Avalanche Victims
- 13 Prehospital Rewarming in Hypothermia. Indications, Methods, Problems and Pitfalls
- 14 Coagulopathies in Hypothermic Patient
- 15 Changes of Pharmacokinetics and Pharmacodynamics of Medications in Hypothermic Patients
- 16 Extracorporeal Therapy in Patients in Severe Hypothermia
- 17 Vascular Access for Extracorporeal Circulation
- 18 Problems and Pitfalls of Qualification for Extracorporeal Treatment of Patients in Severe Hypothermia
- 19 Procedure of Extracorporeal Treatment of Hypothermic Patients
- 20 Recommendation of National Consultant in the Field on Emergency Medicine
- 21 Accidental Hypothermia: the Need for the International Hypothermia Registry
- 22 Qualification for Extracorporeal Rewarming Medical Report
Summary
Accidental hypothermia can be of multiple aetiologies and is often related to an accident in a cold environment and contrasts with urban hypothermia. People living in the cold such as workers, fishermen and military personnel are at risk. More recently there is an increase in unprepared lay people practicing leisure activities such as winter sports, thus exposing themselves to hypothermia in case of an accident. Most of the cases concern mild hypothermia which does not need hospitalization or medical assistance. In contrast, deep hypothermia, with or without cardiac arrest, is rare and carries a high mortality in healthy adults and children [1, 2, 3].
Induced hypothermia which has been used for cardiac surgery as well as therapeutic hypothermia used for brain ischaemia, are medically indicated and highly monitored and therefore cannot be compared to accidental hypothermia. Patients with induced hypothermia may reach the same degree (< 28°C) but are in controlled narcosis and are normally cooled down and rewarmed by Cardiopulmonary Bypass (CPB) [4]. Therapeutic hypothermia cools the patient to mild hypothermia (32–34°C) to enhance a better and faster functional brain recovery [5].
The concept of applying the technique of CPB rewarming, as used in induced deep hypothermic cardiac arrest, to victims of accidental hypothermia with temperatures below 28°C and cardio-respiratory arrest was initiated successfully by Prof. Ueli Althaus at the University Hospital Insel in Bern, Switzerland over 30 years ago [6]. Since that time our team and other Swiss universities started to use this method and we published a multi-centre study showing a long-term sequelae-free survival rate of 47% after rewarming of 32 deep accidental hypothermic patients in cardiac arrest using cardiopulmonary bypass (CPB) [7]. Due to the fact that many patients died from post-rewarming complications, we and others have shown the beneficial effect of using extra-corporeal life support (ECLS) such as prolonged ECMO use after rewarming for cardiovascular and pulmonary dysfunctions [8, 9].
- Type
- Chapter
- Information
- Hypothermia: Clinical Aspects Of Body CoolingAnalysis Of Dangers Directions Of Modern Treatment, pp. 179 - 182Publisher: Jagiellonian University PressPrint publication year: 2016