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Case Reports
. 2021 Jun:63:260-263.
doi: 10.1016/j.jcrc.2021.01.008. Epub 2021 Jan 23.

Successful use of mild therapeutic hypothermia as compassionate treatment for severe refractory hypoxemia in COVID-19

Pablo Cruces  1 , Camila Cores  2 , Daniel Casanova  3 , Federico Pizarro  4 , Franco Díaz  5
Affiliations
Case Reports

Successful use of mild therapeutic hypothermia as compassionate treatment for severe refractory hypoxemia in COVID-19

Pablo Cruces et al. J Crit Care. 2021 Jun.

Abstract

Background: COVID-19 is a disease associated with an intense systemic inflammation that could induce severe acute respiratory distress syndrome (ARDS), with life-threatening hypoxia and hypercapnia. We present a case where mild therapeutic hypothermia was associated with improved gas exchange, facing other therapies' unavailability due to the pandemic.

Case report: A healthy 38-year-old male admitted for COVID-19 pneumonia developed extreme hypoxia (PaO2/FiO2 ratio 42 mmHg), respiratory acidosis, and hyperthermia, refractory to usual treatment (mechanical ventilation, neuromuscular blockade, and prone position), and advanced therapies were not available. Mild therapeutic hypothermia management (target 33-34 °C) was maintained for five days, with progressive gas exchange improvement, which allowed his recovery over the following weeks. He was discharged home after 68 days without significant ICU associated morbidity.

Conclusions: Mild hypothermia is a widely available therapy, that given some specific characteristics of COVID-19, may be explored as adjunctive therapy for life-threatening ARDS, especially during a shortage of other rescue therapies.

Keywords: Acute respiratory distress syndrome; COVID-19; Hypoxemia; Mild hypothermia.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Thoracic computed tomographic scan showing extensive bilateral pulmonary consolidation and pneumomediastinum in a patient with severe ARDS associated with SARS-CoV-2.
Fig. 2
Fig. 2
Effects of mild therapeutic hypothermia on gas exchange in a patient with severe ARDS associated with SARS-CoV-2.
See this image and copyright information in PMC

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