[Treatment of severe accidental hypothermia with a simple extracorporeal circuit]

Abstract

A simple method allows rewarming severe accidental hypothermia patients by an extra-corporal veno-venous circuit. Blood is removed from the femoral vein and brought to infusion pump accelerator which sends it through a blood-rewarmer before reinjecting it into the terminal jugular or sub-clavian vein. This allows the heart to be rewarmed preferentially. The blood is heparinized upon entering the circuit and later neutralized with protamine sulfate upon leaving it. Five severely hypothermic patients (average temperature: 26.5 degrees C) were treated using this technique. Rapid improvement was obtained with disappearance of cardiovascular shock within one hour. Rectal temperature increased by 1.84 degrees C.h-1 and became normal in 6 hours. No complications were encountered. Particularly, there were no incidents of shock due to rapid rewarming and no secondary biological disturbances observed imputable to the extra-corporal circuit. It should be emphasized that the equipment used is readily available in most Emergency and Intensive Care Units.