Abstract
A 43-year-old woman became exhausted and fainted on descent at 1127 MAMSL altitude and snowfall. A rescue team diagnosed asystole. With manual cardiopulmonary resuscitation (CPR) she was transported to the next extracorporeal life support (ECLS) center. Admission temperature was 20.7 °C. CPR continued until ECLS was initiated. Two days later she was awake, orientated, and with no neurological deficits. With hypothermic cardiac arrest, a favorable outcome depends on early continuous CPR, triage, and ECLS rewarming. It holds true that “nobody is dead until they are warmed and dead” if one cools first and arrests thereafter.
Zusammenfassung
Eine 43-jährige Frau erschöpfte sich beim Abstieg auf 1127 m und gleichzeitigem Schneefall. Die Rettungskräfte fanden sie mit einer Asystolie vor. Unter laufender manueller kardiopulmonaler Wiederbelebung („cardiopulmonary resuscitation“, CPR) wurde sie mit dem Helikopter ins nächste Zentrum mit extrakorporaler Wiedererwärmung („extracorporeal life support“, ECLS) transportiert. Die Körperkerntemperatur bei Aufnahme betrug 20,7 °C. Zwei Tage später war sie wach, orientiert und ohne neurologisches Defizit. Frühestmögliche kontinuierliche CPR, Triage und ECLS sind bei durch Hypothermie bedingtem Herzstillstand entscheidend. Dieser Fall bestätigt dass „Niemand tot ist, bis er nicht warm und tot ist“, vorausgesetzt die tiefe Hypothermie tritt vor dem Herzstillstand ein.
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I. Eckert, P. Imboden, P. Paal, and J. Koppenberg declare that they have no competing interests.
This article does not contain any studies with human participants or animals performed by any of the authors. Consent was obtained from all patients identifiable from images or other information within the manuscript. In the case of underage patients, consent was obtained from a parent or legal guardian.
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An erratum to this article is available at http://dx.doi.org/10.1007/s00101-017-0292-6.
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Eckert, I., Imboden, P., Paal, P. et al. Good neurological outcome after accidental hyopthermia presenting with asytole. Anaesthesist 66, 186–188 (2017). https://doi.org/10.1007/s00101-017-0271-y
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DOI: https://doi.org/10.1007/s00101-017-0271-y