The complete quote is, "In the patient with cardiac arrest and hypothermia,
cardiopulmonary bypass is the preferred method of active internal rewarming
because it also provides a circulation, oxygenation and ventilation while
the core body temperature is gradually raised." The statement in the ALS
Manual from RC(UK) goes on to say, "Unfortunately, facilities for
cardiopulmonary bypass are not always available and a combination of methods
may have to be employed".
That statement is virtually the same as the one that appears in the section
covering hypothermia in the International recommendations in 'Resuscitation'
2000;46(1-3):1-448. The references used to support that statement are given
below (I haven't read them myself - judge for yourself).
[1] Schneider SM. Hypothermia: from recognition to rewarming. Emerg Med Rep
1992;13:1-20
[2] Weinberg AD, Hamlet MP, Paturas JL, White RD, McAninch GW. COld Weather
Emergencies: Principles of Patient Management, Branford, Conn: American
Medical Publishing Co, 1990. pp.10-30
[3] Reuler JB. Hypothermia: pathophysiology, clinical settings, and
management. Ann Intern Med 1978;89:519-27
[4] Zell SC, Kurtz KJ. Severe exposure hypothermia: a resuscitation
protocol. Ann Emerg Med 1985;14:339-45
[5] Althaus U, Aeberhard P, Schupbach P, Nachbur BH, Muhlemann W. Management
of profound accidental hypothermia with cardiorespiratory arrest. Ann Surg
1982;195:492-5
Andy
-----Original Message-----
From: The list will be of relevance to all trainees including
undergraduates and [mailto:[log in to unmask]]On Behalf Of
Gautam
Sent: 14 March 2001 17:10
To: [log in to unmask]
Subject: Re: Hypothermic Cardiac Arrest
and later, you wrote...
>I am particually interested in the recommendations from the Resus council
UK
>that
>state " In the patient with cardiac arrest and hypothermia, cardiopulmonary
>bypass is the preferred method of active internal rewarming......."
Is this another case of the resus council using "best guess" in the
absence of (or in spite of the) evidence.
Gautam
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