1Department of Pediatric Anesthesia and Intensive Care, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden. 2Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. 3Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 4Department of Pediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden. 5Department of Medicine, Center for Resuscitation Science, Karolinska Institute, Stockholm, Sweden.
Crit Care Med. 2015 Nov;43(11):e521-5. doi: 10.1097/CCM.0000000000001283.
To report outcome and intensive care strategy in a 7-year-old girl with accidental profound hypothermia and drowning.
Patient records and interviews with search-and-rescue personnel.
Case report.
The girl was rescued after an estimated submersion time of at least 83 minutes in icy sea water. She presented with cardiac arrest, ice in her upper airways, a first-documented nasopharyngeal temperature of 13.8°C, and a serum potassium of 11.3 mmol/L. The patient was slowly rewarmed with extracorporeal membrane oxygenation and made an exceptional recovery after intensive care and a long rehabilitation time.
Excellent outcome is possible in children with body temperature and serum potassium reaching the far limits of previously reported human survival and prolonged submersion time.
报告一名 7 岁女童意外深度体温过低和溺水的预后和重症监护策略。
患者病历和搜救人员访谈。
病例报告。
该女童在冰冷的海水中浸泡至少 83 分钟后获救。她出现心脏骤停，上呼吸道有冰，鼻咽温度首次记录为 13.8°C，血清钾 11.3mmol/L。患者接受体外膜氧合缓慢复温，在重症监护和长时间康复后恢复良好。
即使体温和血清钾达到之前报道的人类生存和长时间浸泡的极限，儿童也可能有极好的预后。
