Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Acta Anaesthesiol Scand. 2021 May;65(5):633-638. doi: 10.1111/aas.13790. Epub 2021 Feb 18.
Extracorporeal cardiopulmonary resuscitation has become a recommended treatment option for patients with severe hypothermia with cardiac arrest. Minimal invasive extracorporeal circulation (MiECC) may offer advantages over the current standard extracorporeal membrane oxygenation (ECMO).
Retrospective cohort analysis of hospital database for patients with accidental hypothermia and extracorporeal rewarming with MiECC admitted between 2010 and 2019.
Overall, six of 17 patients survived to hospital discharge. Eleven patients suffered accidental hypothermia in an alpine and six in an urban setting. Sixteen patients arrived at the hospital under ongoing cardiopulmonary resuscitation (CPR). CPR time was 90 minutes (0-150). Four patients survived from an alpine setting and two from an urban setting with CPR duration of 90 minutes (0-150) and 85 minutes (25-100), respectively. Asphyctic patients tended to have lower survival (one of seven patients). Two patients of six with major trauma survived.
MiECC for extracorporeal rewarming from severe accidental hypothermia is a feasible alternative to ECMO, with comparable survival rates.
体外心肺复苏已成为治疗严重低体温伴心搏骤停患者的推荐治疗选择。微创体外循环（MiECC）可能优于目前的标准体外膜肺氧合（ECMO）。
对 2010 年至 2019 年间因意外低体温并接受 MiECC 体外复温而入院的患者的医院数据库进行回顾性队列分析。
总体而言，17 名患者中有 6 名存活至出院。11 名患者在高山环境中意外低体温，6 名在城市环境中意外低体温。16 名患者在持续心肺复苏（CPR）下到达医院。CPR 时间为 90 分钟（0-150）。4 名来自高山环境的患者和 2 名来自城市环境的患者在 CPR 持续时间为 90 分钟（0-150）和 85 分钟（25-100）时存活下来，分别。窒息患者的存活率往往较低（7 名患者中仅 1 名存活）。6 名严重创伤患者中有 2 名存活。
对于严重意外低体温的体外复温，MiECC 是 ECMO 的可行替代方案，具有相似的生存率。
