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Rewarming from severe hypothermia

caesar ursic cmursic at gmail.com
Sat Dec 19 23:25:35 GMT 2009


I believe that the folks up in Seattle (Meyer, Jurkovich, et al) have
published good results with femoral A-V and/or V-V bypass for rewarming in
trauma.  Might be worth a literature search.

C Ursic, MD
general surgeon



On Fri, Dec 18, 2009 at 4:29 AM, Offner, Patrick
<PatrickOffner at centura.org>wrote:

>
>  Had a recent patient who came to the ED in cardiac arrest with severe
> hypothermia(temp ~70 degrees F). Patient had CPR in the ED for 2 hours
> while waiting for the CT surgeons to come in and do Fem-fem bypass. I
> tried to do it myself but the perfusionist here said they could only
> work with a CT surgeon. The CT guy finally takes the patient to the OR
> and puts the patient on full bypass via median sternotomy--patient
> required ~20 units of blood with that procedure--as well as systemic
> heparin.  He was likely an assault patient but we were never able to
> image him. I argued that fem-fem bypass would have been more
> appropriate--as it was 1. quicker, 2. able to be done with ongoing CPR,
> 3.simpler with less blood loss.
> I am curious what others thoughts and or practice is in the situation of
> rewarming someone like this with CPR in progress? Thanks.
>
>
> Patrick J. Offner MD MPH
> Chief, Surgical Critical Care
> St Anthony Central Hospital
>
>
>
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'Twas brillig, and the slithy toves
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All mimsy were the borogoves,
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