Vom Angelausflug auf die Intensivstation

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• 作者：M. Kippnich (1)
  D. Keller (1)
  J. Jokinen (1)
  C. Kilgenstein (1)
  R.M. Muellenbach (1)
  C. Markus (1)
  N. Roewer (1)
  Prof. Dr. P. Kranke MBA (1)
  
• 关键词：Beinahe ; Ertrinken ; Hypothermie ; K?rpertemperatur ; Intraoss?rer Zugang ; Extrakorporale Membranoxygenierung ; Near drowning ; Hypothermia ; Body temperature ; Intraosseous infusion ; Extracorporeal membrane oxygenation
• 刊名：Der Anaesthesist
• 出版年：2014
• 出版时间：November 2014
• 年：2014
• 卷：63
• 期：11
• 页码：839-843
• 全文大小：453 KB
• 参考文献：1. Durrer B, Brugger H, Syme D et al (2003) The medical on-site treatment of hypothermia: ICAR-MEDCOM recommendation. High Alt Med Biol 4:99-03 CrossRef
  2. Eich C, Brauer A, Kettler D (2005) Recovery of a hypothermic drowned child after resuscitation with cardiopulmonary bypass followed by prolonged extracorporeal membrane oxygenation. Resuscitation 67:145-48 CrossRef
  3. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT et al (2012) Acute respiratory distress syndrome: the Berlin definition. JAMA 307:2526-533
  4. Gilbert M, Busund R, Skagseth A et al (2000) Resuscitation from accidental hypothermia of 13.7 degrees C with circulatory arrest. Lancet 355:375-76 CrossRef
  5. Needham DM, Colantuoni E, Mendez-Tellez PA et al (2012) Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study. BMJ 344:e2124 CrossRef
  6. Ruttmann E, Weissenbacher A, Ulmer H et al (2007) Prolonged extracorporeal membrane oxygenation-assisted support provides improved survival in hypothermic patients with cardiocirculatory arrest. J Thorac Cardiovasc Surg 134:594-00 CrossRef
  7. Silfvast T, Pettila V (2003) Outcome from severe accidental hypothermia in Southern Finland -a 10-year review. Resuscitation 59:285-90 CrossRef
  8. Soar J, Perkins GD, Abbas G et al (2010) European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Resuscitation 81:1400-433 CrossRef
  9. Ujhelyi MR, Sims JJ, Dubin SA et al (2001) Defibrillation energy requirements and electrical heterogeneity during total body hypothermia. Crit Care Med 29:1006-011 CrossRef
  10. Wurmb T, Fruhwald P, Brederlau J et al (2005) The Wurzburg polytrauma algorithm. Concept and first results of a sliding-gantry-based computer tomography diagnostic system. Anaesthesist 54:763-68, 770-72 CrossRef
  
• 作者单位：M. Kippnich (1)
  D. Keller (1)
  J. Jokinen (1)
  C. Kilgenstein (1)
  R.M. Muellenbach (1)
  C. Markus (1)
  N. Roewer (1)
  Prof. Dr. P. Kranke MBA (1)
  
  1. Klinik und Poliklinik für An?sthesiologie, Universit?tsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland
  
• ISSN：1432-055X

文摘

Background In the context of the European Resuscitation Council (ERC) guidelines, modifications of the proposed treatment algorithm need to be performed in order to respond to different parameters. In this respect several factors interacting with cardiac arrest are essential and need to be included in the therapy. This case report demonstrates an example of resuscitation in the situation of hypothermia. Case report After a near drowning accident and approximately 30?min underwater, a patient suffering from severe hypothermia initially required resuscitation after the rescue. A return of spontaneous circulation (ROSC) was successfully achieved within a short length of time and after 15 days on the intensive care unit the patient was discharged to a rehabilitation facility without any signs of focal neurological deficits. Discussion Section 8 of the ERC guidelines provides additional information for resuscitation under specific conditions. In this case report, hypothermia was one of the main criteria leading to an adjusted pharmacological therapy. Furthermore, selection of the appropriate hospital for an optimal advanced treatment including controlled warming of the patient and management of hypothermia-induced complications had to be evaluated.