Severe accidental hypothermia: rewarming strategy using a veno-venous bypass system and a convective air warmer

Objective: To study a rewarming strategy for patients with severe accidenta l hypothermia using a simple veno-venous bypass in combination with a conve ctive air warmer. Setting: Eighteen beds in a university hospital intensive care unit. Patients: Four adults admitted with a core temperature less than 30 degrees C. Hypothermia was caused by alcoholic intoxication in three patients and by drug overdose in one patient. Measurements and main results: All patients were rewarmed by a venovenous b ypass and in three cases a convective air warmer was also used. At a bypass flow rate of 100-300 ml/min the mean increase in core temperature was 1.15 degrees C/h (Range: 1.1-1.2 degrees C/h). One patient died 2 days after re warming as a consequence of a reactivated pancreatitis. The other three pat ients survived without neurological sequelae. Conclusion: This rewarming technique seems safe and effective and allowed t he controlled rewarming of our patients who suffered from severe accidental hypothermia.