Abstract | BACKGROUND: METHODS: An electronic search was performed to identify articles reporting ECLS use for treatment of accidental hypothermia. Only reports describing patients aged more than 16 years after January 1, 2005, were included. Nineteen studies were identified comprising 47 patients. Demographic information, perioperative variables, and outcomes were extracted for analysis. RESULTS: Median patient age was 48 years (interquartile range (IQR), 29 to 56), and 72.3% (34 of 47) were male. On presentation, median body temperature was 24.6°C (IQR, 22.2° to 26°C), median potassium level 4.3 mmol/L (IQR, 3.4 to 4.6 mmol/L), and median Glasgow Coma Scale score 3 (IQR, 3 to 7). Cardiac arrest occurred in 35 of 47 patients (74.5%). Median time to ECLS initiation from scene was 155 minutes (IQR, 113 to 245). Median ECLS duration was 18 hours (IQR, 4 to 27), with median rewarming rate of 2°C per hour (IQR, 1.5° to 4°). Median intensive care unit stay and hospital length of stay were 8 days (IQR, 2 to 16) and 17 days (IQR, 10 to 36), respectively. Inhospital mortality was 19.1% (9 of 47). Median discharge Glasgow Coma Scale score was 15 (IQR, 15 to 15) with minor long-term cognitive impairments noted in 6 of 47 patients (19.4%). Survival was significantly associated with potassium on presentation (P < .001), initial body temperature (P < .001), and ECLS rewarming rate (P < .001). CONCLUSIONS:
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Authors | Melissa A Austin, Elizabeth J Maynes, Thomas J O'Malley, Piotr Mazur, Tomasz Darocha, John W Entwistle, T Sloane Guy, H Todd Massey, Rohinton J Morris, Vakhtang Tchantchaleishvili |
Journal | The Annals of thoracic surgery
(Ann Thorac Surg)
Vol. 110
Issue 6
Pg. 1926-1932
(12 2020)
ISSN: 1552-6259 [Electronic] Netherlands |
PMID | 32504609
(Publication Type: Journal Article, Systematic Review)
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Copyright | Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Topics |
- Extracorporeal Membrane Oxygenation
- Humans
- Hypothermia
(therapy)
- Rewarming
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