Complete Neurological Recovery after Severe Accidental Hypothermia: Two Cases and a Novel Algorithm Proposal
| Autor: | Zewditu Asfaw, Alexander L Marinica, Susan Seman, Thomas M. Hanna, Khortnal Delvecchio, Ingida Asfaw, Calvin Williams |
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| Rok vydání: | 2019 |
| Předmět: |
Accidental hypothermia
business.industry Mentally ill medicine.medical_treatment Treatment method Hypothermia Core temperature Urban community law.invention law Extracorporeal membrane oxygenation Cardiopulmonary bypass General Earth and Planetary Sciences Medicine medicine.symptom business Algorithm General Environmental Science |
| Zdroj: | American Journal of Medical Case Reports. 7:100-103 |
| ISSN: | 2374-2151 |
| Popis: | Primary accidental hypothermia results from endogenous thermoregulatory mechanisms being overwhelmed by environmental stressors. Vulnerable populations include the elderly, mentally ill, homeless, and chemically dependent. When core temperatures fall below 35°C, the resulting metabolic derangements provoke cardiopulmonary compromise and dysrhythmia. Due to the human body’s innate protective mechanisms there are reports of patients making complete neurologic recovery after exposure to extreme temperatures and prolonged cardiopulmonary arrest. We describe two cases from our institution demonstrating appropriate treatment methods for the two most severe stages of hypothermia. A 57-year-old male with a core temperature of 27°C who was successfully resuscitated with warm bladder and thoracic lavage and a 34-year-old female with a core temperature of 22°C that fully recovered after 5 hours of external cardiopulmonary bypass. From our experience and a review of the literature, we have developed a modified version of the Swiss staging model and incorporated it into a novel treatment algorithm for in-hospital adult accidental hypothermia patients presenting to urban community hospitals. The two example cases described highlight how appropriate utilization of this novel algorithm can lead to positive outcomes in otherwise critical clinical scenarios. |
| Databáze: | OpenAIRE |
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