Morley David, Yamane Kentaro, O'Malley Rika, Cavarocchi Nicholas C, Hirose Hitoshi
Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA, U.S.A.
Am J Case Rep. 2013;14:6-9. doi: 10.12659/AJCR.883728. Epub 2013 Jan 8.
Accidental hypothermia complicated by cardiac arrest carries a high mortality rate in urban areas. For moderate hypothermia cases conventional rewarming methods are usually adequate, however in severe cases extracorporeal membrane oxygenation (ECMO) is known to provide the most efficient rewarming with complete cardiopulmonary support. We report a case of severe hypothermia complicated by prolonged cardiac arrest successfully resuscitated using ECMO.
A 45 year old female was brought to our emergency department with a core body temperature <25°C. Shortly after arrival she had witnessed cardiac arrest in the department. Resuscitative efforts were started immediately including conventional rewarming techniques, followed by ECMO support. ECMO was used successfully in this case to resuscitate this patient from prolonged arrest (3.5 hours) when conventional techniques likely would have failed. After a prolonged hospital course this patient was discharged with her baseline mental and physical capacities intact.
This case demonstrates the advantages of advanced internal rewarming techniques, such as ECMO, for quick and efficient rewarming of severely hypothermic patients. This case supports the use of ECMO in severely hypothermic patients as the standard of care.
在城市地区，意外低温合并心脏骤停的死亡率很高。对于中度低温病例，传统的复温方法通常就足够了，然而在严重病例中，体外膜肺氧合（ECMO）已知能在提供完全心肺支持的情况下实现最有效的复温。我们报告一例严重低温合并长时间心脏骤停的病例，该病例使用ECMO成功复苏。
一名45岁女性被送至我院急诊科，核心体温<25°C。到达后不久，她在科室发生心脏骤停，被目击。立即开始复苏努力，包括传统复温技术，随后给予ECMO支持。在该病例中，当传统技术可能失败时，ECMO成功用于使该患者从长时间心脏骤停（3.5小时）中复苏。经过漫长的住院过程，该患者出院时精神和身体能力恢复到基线水平。
该病例证明了先进的体内复温技术，如ECMO，对于严重低温患者快速有效地复温的优势。该病例支持将ECMO用于严重低温患者作为标准治疗方法。
