- Page navigation anchor for RE: Ting, D. K., & Brown, D. J. (2018). Use of extracorporeal life support for active rewarming in a hypothermic, nonarrested patient with multiple trauma. CMAJ, 190(23), E718-E721.RE: Ting, D. K., & Brown, D. J. (2018). Use of extracorporeal life support for active rewarming in a hypothermic, nonarrested patient with multiple trauma. CMAJ, 190(23), E718-E721.
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With interest, we followed the case report by Ting and Brown of a severely hypothermic trauma patient treated with ECLS. In addition to this situation, we report a case of a polytraumatized hypothermic patient who arrived in cardiac arrest after a fall of 30 meters in the mountains [1].
Due to bad weather, the HEMS team had reached the 59-year-old man 4 hours after trauma only. They found a patient with signs of cardiac instability and a GCS of 9/15. During transport to the level I trauma center, he sustained cardiac arrest. On arrival, the patient was under CPR, showed ventricular fibrillation, a core temperature of 25.3oC, and potassium was 2.7 mmol/l. The receiving team decided to proceed according to our Bernese Hypothermia Algorithm [2] and to rewarm him with limited trauma assessment. The assessment, which was done simultaneously with cannulation of the groin, included a primary survey and e-FAST to exclude major hemorrhage. As large bleeding could be excluded, the team decided to start the active invasive rewarming using the Mini-ECC [3]. During rewarming, he underwent a full trauma assessment using our local polytrauma protocol. The contrast CT scan - amongst others - showed serial rib fractures with hemo-pneumothorax, an open book pelvic fracture, a pertrochanteric femur fracture and an active hemorrhage from a lumbar artery. The arterial bleeding was successfully embolized. Subsequently, the patient underwent several orthopedic interventio...Competing Interests: None declared.
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