Severe accidental hypothermia: rewarming strategy using a veno-venous bypass system and a convective air warmer.

Abstract

To study a rewarming strategy for patients with severe accidental hypothermia using a simple veno-venous bypass in combination with a convective air warmer. Eighteen beds in a university hospital intensive care unit. Four adults admitted with a core temperature less than 30 degrees C. Hypothermia was caused by alcoholic intoxication in three patients and by drug overdose in one patient. All patients were rewarmed by a venovenous bypass and in three cases a convective air warmer was also used. At a bypass flow rate of 100-300 ml/min the mean increase in core temperature was 1.15 degrees C/h (Range: 1.1-1.2 degrees C/h). One patient died 2 days after rewarming as a consequence of a reactivated pancreatitis. The other three patients survived without neurological sequelae. This rewarming technique seems safe and effective and allowed the controlled rewarming of our patients who suffered from severe accidental hypothermia