Use of extracorporeal life support for active rewarming in a hypothermic, nonarrested patient with multiple trauma

A 53-year-old man was driving in the winter when he was involved in a single-vehicle collision in the early morning hours (around 4:30). The vehicle traveled down a six-meter embankment and struck several large trees. The man was not wearing a seatbelt and was ejected through the windshield, ending...

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Published in:Canadian Medical Association journal (CMAJ) 2018-06, Vol.190 (23), p.E718-E721
Main Authors: Ting, Daniel K., MD, Brown, Douglas J.A., MD
Format: Article
Language:English
Subjects:
Accidents, Traffic
Blood pressure
Cardiac arrhythmia
Care and treatment
Case studies
Cold Temperature - adverse effects
Coma
Emergency medical care
Emergency services
Esophagus
Extracorporeal Circulation
Extracorporeal Membrane Oxygenation - methods
Heart rate
Hospitals
Humans
Hypothermia
Hypothermia - physiopathology
Hypothermia - therapy
Intensive care
Internal Medicine
Life support care
Male
Medical imaging
Medicine
Middle Aged
Mortality
Multiple Trauma - physiopathology
Multiple Trauma - therapy
Patient outcomes
Patients
Practice
Rewarming - methods
Snow
Surgeons
Trauma
Treatment Outcome
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container_title Canadian Medical Association journal (CMAJ)
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Brown, Douglas J.A., MD
description A 53-year-old man was driving in the winter when he was involved in a single-vehicle collision in the early morning hours (around 4:30). The vehicle traveled down a six-meter embankment and struck several large trees. The man was not wearing a seatbelt and was ejected through the windshield, ending up pinned under a tree. The ambient temperature was about -20°C. The initial assessment by the paramedics documented a Glasgow Coma Scale score of 8, a heart rate of 42, and a blood pressure of 61/43. They placed a tibial intraosseous line and intubated the patient under direct laryngoscopy. They measured an esophageal temperature of 23.5°C. The patient was transported via air ambulance under full spinal precautions to the regional trauma and extracorporeal life support center. Here, Ting and Brown report the case of a nonarrested patient with severe accidental hypothermia and multiple trauma who had a full neurologic recovery after undergoing extracorporeal life support for primary rewarming.
doi_str_mv 10.1503/cmaj.180117
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subjects Accidents, Traffic
Blood pressure
Cardiac arrhythmia
Care and treatment
Case studies
Cold Temperature - adverse effects
Coma
Emergency medical care
Emergency services
Esophagus
Extracorporeal Circulation
Extracorporeal Membrane Oxygenation - methods
Heart rate
Hospitals
Humans
Hypothermia
Hypothermia - physiopathology
Hypothermia - therapy
Intensive care
Internal Medicine
Life support care
Male
Medical imaging
Medicine
Middle Aged
Mortality
Multiple Trauma - physiopathology
Multiple Trauma - therapy
Patient outcomes
Patients
Practice
Rewarming - methods
Snow
Surgeons
Trauma
Treatment Outcome
title Use of extracorporeal life support for active rewarming in a hypothermic, nonarrested patient with multiple trauma
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