Accidental hypothermia. Core rewarming with partial bypass

Per Wickstrom, Ernest Ruiz, G. Patrick Lilja, J. Peter Hinterkopf, John J. Haglin

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62 Scopus citations


Three patients with profound hypothermia were treated by rewarming on partial bypass. Two survived and have normal mental and metabolic functions. The resuscitation of the hypothermic patient should be approached with enthusiasm since the outcome is often much better than expected from initial vital signs and neurologic examination. To avoid ventricular fibrillation the patient should be handled gently and an effort should be made to keep the patient well oxygenated and the pH normal. Blood gases should be measured often and corrected for temperature. The potassium concentration and hydration status of the patient should also be monitored closely. The rewarming of profoundly hypothermic patients can readily be accomplished with a pump oxygenator and heat exchanger. The indications for this method are not established from our small experience and the few cases reported in the literature. Certainly ventricular fibrillation is a compelling indication. Patients with frozen extremities might also benefit from this method since theoretically tissue salvage would be increased. Finally, those patients who do not respond rapidly to external rewarming may be at less risk of ventricular fibrillation if rewarmed on bypass.

Original languageEnglish (US)
Pages (from-to)622-625
Number of pages4
JournalThe American Journal of Surgery
Issue number5
StatePublished - May 1976

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