2018 Volume 9 Issue 2 Pages 121-124
We report the cases of three patients with internal rewarming for whom hemodialysis (HD) was used to treat accidental hypothermia. All patients were elderly Japanese men, and the severity of their hypothermia was mild to severe. After external rewarming, HD was initiated to achieve a rewarming rate of 2℃/hr. In the mild hypothermia case, rewarming shock occurred within 2 hr of starting HD. In the most severe case, the starting dialysate temperature was set at 34℃, and the blood flow was 80 mL/min to avoid risks such as the induction of ventricular fibrillation caused by rapid temperature restoration. In this patient, the HD was stopped after a total of 3 hr, when the patient became more alert and his rectal temperature reached 30℃. The temperature of each patient’s blood circuit was measured using thermography (FLIR® i3, FLIR Systems, Boston, MA) and controlled appropriately. Although HD is a useful method for treating severe hypothermia, it is necessary to control the rate of rewarming and body temperature carefully to prevent side effects due to rewarming.
