Authors

K Cockayne, P Hall, L Beare, R Warwick & K Mazhar

Background

Accidental Hypothermia (AH) with / without Cardiac Arrest (AHCA) requiring rewarming via Extra-Corporeal Life Support (ECLS) is a rare phenomenon and thus the management of these patients often presents a clinical challenge. There is currently no nationally accepted standards or protocols for this cohort of patients.

We sought to investigate and understand the experience of members of the Society of Clinical Perfusion Scientists Great Britain & Ireland (SCPS) working in individual cardiothoracic centres to help address this gap literature.

Methods

An electronic survey was sent out to clinical perfusion scientists of the SCPS. The study was limited to individual centres experience of AHCA in the past 10 years. Results were tabulated and duplicate responses from each centre were excluded from final analysis.

Results

Results from 18 centres (13 Adult only, 3 paediatric only, 2 both adult and paediatric) were analysed. 14 centres (78%) said they accepted patients for AHCA rewarming. A total of 31 respondents’ patients have been rewarmed using ECLS (range 0-8) in the past decade.  25 patients (81%) were above 16 years of age. 9 patients (29%) were successfully weaned from ECLS (Range 0-4). Most cases (n = 15) employed Median Sternotomy for ECLS access. However, only 4 centres (22%) said they follow a structured SOP for management of AHCA.  

Conclusions

Based on the results of this national survey: AHCA patients who undergo ECLS rewarming are a rare occurrence but with a poor prognosis. Further work and data collection is required in order to risk stratify this group of patients to provide an optimal triage and resuscitation evidence base to improve patient mortality and morbidity.

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