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Treatment of severe accidental hypothermia with intermittent hemodialysis

Published online by Cambridge University Press:  21 May 2015

Nabil Sultan ,
Karl D. Theakston ,
Ron Butler  and
Rita S. Suri
Nabil Sultan
Affiliation:
Division of Nephrology, University of Western Ontario, London, Ont.
Karl D. Theakston
Affiliation:
Division of Emergency Medicine, University of Western OntarioLondon, Ont.,
Ron Butler
Affiliation:
Division of Critical Care, University of Western Ontario, London, Ont.
Rita S. Suri*
Affiliation:
Division of Nephrology, University of Western Ontario, London, Ont.
*
Kidney Clinical Research Unit, Rm. ELL-119, Victoria Hospital, London Health Sciences Centre, 800 Commissioners Rd. E, London ON N6A 4G5, [email protected]

Abstract

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The optimal management of moderate-to-severe hypothermia with hemodynamic instability remains unclear. Although cardiopulmonary bypass offers the most rapid rate of rewarming and has been suggested as the method of choice in the presence of circulatory arrest, there is no evidence to support the use of this highly invasive technique over other rewarming modalities in the absence of circulatory collapse. We report the successful treatment of hemodynamically unstable hypothermia with conventional hemodialysis in a patient with normal renal function, after initial efforts of rewarming using conventional strategies had failed. This case report and review of the literature highlights the advantages and the challenges of using hemodialysis in this setting, and suggests a potential role for hemodialysis in the routine management of moderate-to-severe hypothermia in the absence of circulatory arrest.

Keywords

hypothermiadialysisrewarmingafter-drophypotension
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 2 , March 2009 , pp. 174 - 177
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

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