Is cardiopulmonary bypass effective for treatment of hypothermic arrest due to drowning or exposure?
G. V. Letsou, G. S. Kopf, J. A. Elefteriades, J. E. Carter, J. C. Baldwin and G. L. Hammond
Division of Cardiothoracic Surgery, Yale University, New Haven, Conn.
Various techniques have been advocated for resuscitation from hypothermic
arrest caused by ice-cold freshwater drowning or exposure. We have
resuscitated five such patients after emergency hospital admission using
cardiopulmonary bypass initiated via median sternotomy. All patients
presented to our facility with core temperatures less than 26 degrees C.
Three patients had been in full cardiopulmonary arrest for more than 30
minutes prior to arrival. The fourth patient presented in ventricular
fibrillation; the fifth was admitted to the hospital in sinus bradycardia
that quickly deteriorated to asystole. All had cardiopulmonary bypass
emergently initiated via median sternotomy. All were rewarmed on bypass to
37 degrees C and all survived at least 24 hours. Three of the five patients
are currently alive and well with normal neurologic function.
Cardiopulmonary bypass is an effective technique for resuscitation after
hypothermic arrest due to near drowning and/or exposure.
