Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
Emerg Med J. 2010 Dec;27(12):958-9. doi: 10.1136/emj.2009.078865. Epub 2010 Oct 29.
Hypothermic cardiac arrest is a relatively uncommon presentation to United States Emergency Departments. During 1979-2002, the Centers for Disease Control reported that an average of 689 deaths per year in the US were attributed to exposure to excessive natural cold. Severe hypothermia (<30°C) confers marked depression of critical metabolic and biochemical functions, but may also provide protection to the brain and other organs while resuscitation is undertaken. For all hypothermic patients, measures designed to prevent further heat loss and begin rewarming should be instituted, but should not delay routine Advanced Cardiac and Trauma Life Support procedures. Rewarming methods include passive rewarming (insulation, removal from environment), active external rewarming (heating blankets, radiant heat, warm water immersion), and active core rewarming (warm inhalation, warmed intravenous fluids, gastrointestinal irrigation, bladder irrigation, dialysis, thoracostomy lavage, and cardiopulmonary bypass).
低温心脏骤停在美国急诊部门相对少见。1979 年至 2002 年期间，疾病控制中心报告称，美国每年平均有 689 人因暴露于过度自然寒冷而死亡。严重低温（<30°C）会显著抑制关键代谢和生化功能，但在进行复苏时，也可能为大脑和其他器官提供保护。对于所有低温患者，都应采取措施防止进一步散热并开始复温，但不应延迟常规高级心脏和创伤生命支持程序。复温方法包括被动复温（隔热、脱离环境）、主动外部复温（加热毯、辐射热、温水浸泡）和主动核心复温（温暖吸入、温热静脉输液、胃肠灌洗、膀胱灌洗、透析、胸腔冲洗和心肺旁路）。
