Severe hypothermia with cardiac arrest: complete neurologic recovery in a 4-year-old child.

A 4-year-old girl was lost for 17 hours in a snowstorm. Upon discovery, her core temperature was 72 degrees F (22 degrees C). While undergoing endotracheal intubation in the emergency department, she experienced sudden ventricular fibrillation and cardiac arrest. Closed chest cardiopulmonary resuscitation (CPR) was instituted, and standard rewarming measures were begun. Despite this, neither core temperature, nor the patient's arrhythmia, changed. An infraumbilical "mini-laparotomy" incision was made, with placement of a large silicone peritoneal dialysis catheter into the abdomen. This was then connected to a rapid infuser device, with the delivery of 1L of warmed, normal saline every 90 seconds. The core temperature reached 29 degrees C in 15 minutes, and a palpable pulse was detected. Lavage was continued until core temperature reached 34 degrees C, at which time transport to the pediatric intensive care unit was arranged. She was extubated the next day and discharged home, on the fourth hospital day, with apparent complete neurologic recovery. This is the first report of the successful use of rapid high-volume peritoneal lavage for the treatment of accidental severe hypothermia in a pediatric patient.

Papenhausen M ，Burke L ，Antony A ，Phillips JD ... -  《JOURNAL OF PEDIATRIC SURGERY》

[Resuscitation from accidental hypothermia of 22 degrees C with circulatory arrest: importance of prehospital management].

Incagnoli P ，Bourgeois B ，Teboul A ，Laborie JM ... -  《annales francaises d anesthesie et de reanimation》

2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support.

American Heart Association 《-》

Surviving two hours of ventricular fibrillation in accidental hypothermia.

Nordberg P ，Ivert T ，Dalén M ，Forsberg S ，Hedman A ... -  《-》

[Severe accidental hypothermia in an elderly woman].

Knobel B ，Mikhlin A 《-》