Document Detail


An established extracorporeal membrane oxygenation protocol promotes survival in extreme hypothermia.
MedLine Citation:
PMID:  18082698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  42     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-17     Completed Date:  2008-01-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2012-6     Citation Subset:  IM    
Affiliation:
IRB 0020292, University of Utah Institutional Review Board, Salt Lake City, UT 84113-1103, USA. eric.scaife@hsc.utah.edu
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MeSH Terms
Descriptor/Qualifier:
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

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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