Extracorporeal rewarming can be effective in patients with accidental hypothermia. A number of factors may increase the risk for a poor outcome.
Factors associated with a poor outcome in accidental hypothermia:
(1) hypoxic arrest, asphyxia
(2) serum potassium > 10 mmol/L
(3) older age (use >= 65 years in implementation)
(4) elevated serum creatinine with low urine output
(5) persistent metabolic acidosis with hyperlactatemia (failure to clear)
(6) cardiocirculatory instability
where:
• In the study of Kosinski et al. serum lactate at 8 hours was less than 50% of the admission serum lactate.
• Several of the findings indicate poor tissue perfusion.
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Specialty: Emergency Medicine