| An established extracorporeal membrane oxygenation protocol promotes survival in extreme hypothermia. | |
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MedLine Citation:
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PMID: 18082698 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Historical reports indicate that active rewarming with extracorporeal membrane oxygenation (ECMO) can salvage a patient after hypothermic cardiac arrest. We created a protocol that includes ECMO for extreme hypothermia to guide rewarming of the hypothermic patient. METHODS: A retrospective review of the ECMO rewarming protocol (2004-2006) was conducted. RESULTS: The active rewarming protocol is a flowchart that is available on our hospital intranet and can be accessed in the trauma bay. A severely hypothermic patient triggers the activation of a TRAUMA ONE-OP ECMO response. During the 2-year period, there were 5 activations of the system and 4 children were placed on ECMO. Two of the 4 were dramatically salvaged and eventually discharged neurologically intact. All 5 children were found pulseless at the scene before transport. The average time from the injury occurrence to arrival was 94 minutes (range, 41-181 minutes). Mean cardiopulmonary resuscitation time was 78.2 minutes (range, 37-152 minutes). The mean core temperature on arrival was 25.4 degrees C (range, 20.4 degrees C-28.6 degrees C). The average time from arrival to ECMO cannulation was 25.5 minutes (range, 16-37 minutes). CONCLUSION: A preemptive strategy for the severely hypothermic patient provides an organized approach and prompt response. Expeditious rewarming can make the difference in an opportunity for survival. |
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Authors:
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Eric R Scaife; R C Connors; S E Morris; P F Nichol; R E Black; M E Matlak; K Hansen; R G Bolte |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 42 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-12-17 Completed Date: 2008-01-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 2012-6 Citation Subset: IM |
Affiliation:
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IRB 0020292, University of Utah Institutional Review Board, Salt Lake City, UT 84113-1103, USA. eric.scaife@hsc.utah.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Child, Preschool Extracorporeal Membrane Oxygenation / methods* Female Follow-Up Studies Heart Arrest / etiology, mortality*, therapy* Humans Hypothermia / complications, mortality*, therapy* Infant Male Retrospective Studies Risk Assessment Sensitivity and Specificity Survival Rate Treatment Outcome |
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