One of the complications of severe accidental hypothermia is reversible hypothermic cardiogenic shock. Extracorporeal membrane oxygenation (ECMO) can preserve circulation while also rewarming the victim. Saczkowski et al reported the ICE score for predicting survival in ECMO-treated patients.
Patient selection: severe accidental hypothermia with cardiogenic shock and hemodynamic instability
The prognosis is dependent on appropriate coordination of the rescue operation, immediate high-quality CPR, and the use of ECMO for rewarming and cardiorespiratory support.
Parameters for the ICE score:
(1) sex
(2) asphyxiation
(3) serum potassium in mmol/L
Parameter
Finding
Points
sex
male
0
female
-3
asphyxiation
no
0
yes
5
serum potassium
< 5 mmol/L
0
5 to 10 mmol/L
5
> 10 mmol/L
10
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: -3
• maximum score: 15
Score
Overall Survival
-3
86%
0
61%
2
50%
5
32%
7
20%
10
8%
12 or 15
0%
Performance of the ICE score:
• The area under the ROC curve is 0.85.
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