抄録
Severe accidental hypothermia is associated with marked depression of the brain and cardiovascular function and carries a high risk of mortality. We present three such cases with core temperatures between 18 and 27°C. Two of these patients had cardiac arrest on arrival at the emergency department. Rapid rewarming and successful recovery of spontaneous circulation was accomplished by a combination of direct cardiac compression and continuous irrigation of the pericardial cavity with warm fluids (42°C) in one of the patients with cardiac arrest. The best choice of treatment for severe hypothermia complicated by cardiac arrest is partial cardiopulmonary bypass, but this modality is not readily available in many settings. In such cases, a combination of direct cardiac compression and continuous pericardial irrigation is the best available alternative. Other rewarming modalities for severe hypothermia syndrome are also reviewed.
