An established extracorporeal membrane oxygenation protocol promotes survival in extreme hypothermia.
J Pediatr Surg
; 42(12): 2012-6, 2007 Dec.
Article
en En
| MEDLINE
| ID: mdl-18082698
ABSTRACT
BACKGROUND:
Historical reports indicate that active rewarming with extracorporeal membrane oxygenation (ECMO) can salvage a patient after hypothermic cardiac arrest. We created a protocol that includes ECMO for extreme hypothermia to guide rewarming of the hypothermic patient.METHODS:
A retrospective review of the ECMO rewarming protocol (2004-2006) was conducted.RESULTS:
The active rewarming protocol is a flowchart that is available on our hospital intranet and can be accessed in the trauma bay. A severely hypothermic patient triggers the activation of a TRAUMA ONE-OP ECMO response. During the 2-year period, there were 5 activations of the system and 4 children were placed on ECMO. Two of the 4 were dramatically salvaged and eventually discharged neurologically intact. All 5 children were found pulseless at the scene before transport. The average time from the injury occurrence to arrival was 94 minutes (range, 41-181 minutes). Mean cardiopulmonary resuscitation time was 78.2 minutes (range, 37-152 minutes). The mean core temperature on arrival was 25.4 degrees C (range, 20.4 degrees C-28.6 degrees C). The average time from arrival to ECMO cannulation was 25.5 minutes (range, 16-37 minutes).CONCLUSION:
A preemptive strategy for the severely hypothermic patient provides an organized approach and prompt response. Expeditious rewarming can make the difference in an opportunity for survival.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Oxigenación por Membrana Extracorpórea
/
Paro Cardíaco
/
Hipotermia
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
J Pediatr Surg
Año:
2007
Tipo del documento:
Article
País de afiliación:
Estados Unidos