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Hypothermic Cardiac Arrest

Date Last Search Run: Feb 01, 2022
Table last updated: May 02, 2021
Data last added: Jun 30, 2021

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)      
2 (fair evidence exists)    
3 (weak evidence exists)    


Interventions

AER (Active External Rewarming)
Level Direction Primary Outcome Patient/Process Setting Reference
III Supportive (Green) Rewarming Patient PH-Paramedic Kornberger E., Schwartz B., Linder KH., Mair P. Forced air surface re-warming in patients with severe accidental hypothermia. Resuscitation 1991; 41:105-11. Medline
III Supportive (Green) Successful resuscitation without deficit Patient PH-Paramedic Schmidt U., Fritz KW., Kasperczyk W., Tscherne H. Successful resuscitation of a child with severe hypothermia after cardiac arrest of 88 minutes. Prehosp Disaster Med 1995; 10(1):60-2. Medline
III Supportive (Green) Successful resuscitation Patient ED-MD Thompson DA., Anderson N. Successful resuscitation of a severely hypothermic neonate. Ann Emerg Med 1994; 23(6):1390-1393. Medline
III Neutral (Yellow) Efficacy Patient Little G. Accidental hypothermic cardiac arrest and rapid mediastinal warming with pleural lavage: a survivor after 3.5 hours of manual CPR. BMJ case reports 2017. Medline
X Not Yet Graded (White) - Walpoth BH, Brodmann Maeder M, Courvosier DS, Meyer M, Cools E, Darocha T, et al. Hypothermic Cardiac Arrest - Retrospective cohort study from the International Hypothermia Registry. Resuscitation 2021;167:58–65. Medline

Chest Compression devices
Level Direction Primary Outcome Patient/Process Setting Reference

Delayed Defibrillation
Level Direction Primary Outcome Patient/Process Setting Reference

Delayed Drug Administration
Level Direction Primary Outcome Patient/Process Setting Reference

Prolonged Resuscitation
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) Survival Patient PH-Paramedic Masaki F., et al. Revival from deep hypothermia after 4 hours of cardiac arrest without the use of extracorporeal circulation. J Trauma. 2009; 67(5):E173-6. Medline
III Supportive (Green) Survival Patient ED-MD Chochinov AH., Baydock BM., Bristow GK., Giesbrecht GG. Recovery of a 62-year-old man from prolonged cold water submersion. Ann Emerg Med 1998; 31(1):127-31. Medline
III Supportive (Green) neurocognitive outcome Process PH-Paramedic & CCT Kriz D., Piantino J., Fields D., Williams C. Pediatric Hypothermic Submersion Injury and Protective Factors Associated with Optimal Outcome A Case Report and Literature Review. Children (Basel, Switzerland) 2017; 5(1). Medline
III Supportive (Green) Survival Patient ED-MD Lee CH., Van Gelder C., Burns K., Cone DC. Advanced cardiac life support and defibrillation in severe hypothermic cardiac arrest. Prehosp Emerg Care 2009; 13(1):85-9. Medline
III Supportive (Green) Survival Process ED-MD Little G. Accidental hypothermic cardiac arrest and rapid mediastinal warming with pleural lavage a survivor after 3.5 hours of manual CPR. BMJ case reports 2017; 2017. Medline
III Supportive (Green) Successful resuscitation without deficit Patient PH-Paramedic Schmidt U., Fritz KW., Kasperczyk W., Tscherne H. Successful resuscitation of a child with severe hypothermia after cardiac arrest of 88 minutes. Prehosp Disaster Med 1995; 10(1):60-2. Medline
III Supportive (Green) Successful resuscitation Patient ED-MD Thompson DA., Anderson N. Successful resuscitation of a severely hypothermic neonate. Ann Emerg Med 1994; 23(6):1390-1393. Medline
III Neutral (Yellow) Efficacy Patient Little G. Accidental hypothermic cardiac arrest and rapid mediastinal warming with pleural lavage: a survivor after 3.5 hours of manual CPR. BMJ case reports 2017. Medline
III Neutral (Yellow) Restoration of spontaneous circulation Patient ED-MD Sumann G., Krismer AC., Wenzel V., et al. Cardiopulmonary resuscitation after near drowning and hypothermia: Restoration of spontaneous circulation after vasopressin. Acta Anaesthesiol Scand 2003; 47(3):363-365. Medline
III Neutral (Yellow) Case report Patient ED-MD Wik L., Kiil S. Use of an automatic mechanical chest compression device (LUCAS) as a bridge to establishing cardiopulmonary bypass for a patient with hypothermic cardiac arrest. Resuscitation 2005; 66(3):391-394. Medline

Temperature Monitoring
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) Sensitivity and Specificity Process Niven DJ., Gaudet JE., Laupland KB., Mrklas KJ., Roberts DJ., Stelfox HT. Accuracy of Peripheral Thermometers for Estimating Temperature: A Systematic Review and Meta-analysis. Ann Intern Med 2015; 163:768-77. Medline

Transport to an ECMO capable facility
Level Direction Primary Outcome Patient/Process Setting Reference
III Supportive (Green) Survival with good neurological outcome Process ED-MD Podsiadło P, Darocha T, Svendsen ØS, Kosiński S, Silfvast T, Blancher M, et al. Outcomes of patients suffering unwitnessed hypothermic cardiac arrest rewarmed with extracorporeal life support: A systematic review. Artif Organs 2020. Medline


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