IMPORTANT ASPECTS IN THE TREATMENT OF SEVERE ACCIDENTAL HYPOTHERMIA -THE INNSBRUCK EXPERIENCE

The purpose of this paper is to review important aspects in the treatm ent of accidental hypothermia, based on our own experience in rewarmin g 55 patients with severe accidental hypothermia and a core temperatur e <30 degrees C. We used three different methods of rewarming, adjuste d to the patients' hemodynamics: airway rewarming, warmed fluids and i nsulation in patients with stable hemodynamics (group 1, n = 24), peri toneal dialysis in patients with unstable hemodynamics (group 2, n = 7 ) and extracorporeal circulation in patients with cardiocirculatory ar rest (group 3, n = 24). Survival rates were 100% (group 1), 72% (group 2) and 13% (group 3) retrospectively. Published data supporting our s trategy and alternative approaches are reviewed. The method used to re warm a patient with severe accidental hypothermia should be adjusted t o the hemodynamic status. The prognosis is excellent in patients in wh om no hypoxic event precedes hypothermia and no serious underlying dis ease exists.