Online Case Report

Excellent Outcome With Extracorporeal Membrane Oxygenation After Accidental Profound Hypothermia (13.8°C) and Drowning

Romlin, Birgitta S. MD, PhD¹; Winberg, Helena MD¹; Janson, Magnus MD¹; Nilsson, Boris MD¹; Björk, Kerstin CCP²; Jeppsson, Anders MD, PhD^2,3; Drake, Gunilla MD⁴; Claesson, Andreas RN, PhD⁵

Author Information

¹Department of Pediatric Anesthesia and Intensive Care, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.

²Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.

³Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

⁴Department of Pediatrics, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.

⁵Department of Medicine, Center for Resuscitation Science, Karolinska Institute, Stockholm, Sweden.

Dr. Jeppsson participated in advisory boards for AstraZeneca, CSL Behring, Boehringer-Ingelheim, and Roche Diagnostics. His institution received research grants from AstraZeneca and CSL Behring for investigator-initiated studies. The remaining authors have disclosed that they do not have any potential conflicts of interest.

For information regarding this article, E-mail: [email protected]

Critical Care Medicine 43(11):p e521-e525, November 2015. | DOI: 10.1097/CCM.0000000000001283

Abstract

Objective:

To report outcome and intensive care strategy in a 7-year-old girl with accidental profound hypothermia and drowning.

Data Sources and Extraction:

Patient records and interviews with search-and-rescue personnel.

Study Selection:

Case report.

Data Synthesis:

The girl was rescued after an estimated submersion time of at least 83 minutes in icy sea water. She presented with cardiac arrest, ice in her upper airways, a first-documented nasopharyngeal temperature of 13.8°C, and a serum potassium of 11.3 mmol/L. The patient was slowly rewarmed with extracorporeal membrane oxygenation and made an exceptional recovery after intensive care and a long rehabilitation time.

Conclusion:

Excellent outcome is possible in children with body temperature and serum potassium reaching the far limits of previously reported human survival and prolonged submersion time.