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Kardiopulmonale Reanimation nach Heroinintoxikation und Hypothermie

Cardiopulmonary resuscitation after heroin intoxication and hypothermia

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Zusammenfassung

Im Folgenden wird über eine 21-jährige polytoxikomane Patientin mit schwerer akzidenteller Hypothermie (Körperkerntemperatur 27,5°C) und Herz-Kreislauf-Stillstand berichtet. Nach erfolgreicher kardiopulmonaler Reanimation wurde die Patientin aktiv intern ohne Herz-Lungen-Maschine erwärmt. Obwohl die Patientin primär klinisch tot erschien, überlebte sie ohne neurologisches Defizit. In diesem Fallbericht werden Epidemiologie, Pathophysiologie, mögliche Prognose-Scores und unterschiedliche Behandlungsmethoden der schweren Hypothermie diskutiert.

Abstract

We present the case of a 21-year-old female drug addict with severe accidental hypothermia (core body temperature 27.5°C) and cardiorespiratory arrest. After successful cardiopulmonary resuscitation the patient was actively internally rewarmed without the use of extracorporal circulation. Although at the first clinical presentation the patient appeared to be dead, an excellent neurological outcome was achieved. This case report reviews the epidemiology, pathophysiology, prognostic markers and the therapeutic approaches of severe hypothermia.

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Literatur

  1. American Heart Association (2005) Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 112 [Suppl 24]: IV136–138

  2. Baraka AS, Baroody MA, Haroun ST et al. (1992) Effect of alpha-stat versus pH-stat strategy on oxyhemoglobin dissociation and whole body oxygen consumption during hypothermia cardiopulmonary bypass. Anesth Analg 74(1): 32–37

    Article  PubMed  Google Scholar 

  3. Bouachour G, Alquier P (1993) Épidémiologie des hypothermies accidentelles. Act Réanimat Urgen : 245–256

  4. Brugger H, Falk M, Adler-Kastner L (1997) Der Lawinenunfall. Neue Aspekte zur Pathophysiologie und zur Therapie von Lawinenverschütteten. Wien Klin Wochenschr 109(5): 145–159

    PubMed  Google Scholar 

  5. Corneli HM (1992) Accidental hypothermia. J Pediatr 120: 671–679

    Article  PubMed  Google Scholar 

  6. Danzl D (2001) Accidental hypothermia. In: Auerbach P (ed) Wilderness medicine, 4th edn. Mosby, St. Louis, pp 148

  7. Danzl D (2002) Accidental hypothermia. In: Marx JA (ed) Rosen’s emergency medicine: concepts and clinical practice, 5th edn. Mosby, St. Louis, pp 1985

  8. Danzl DF, Pozos RS (1994) Accidental hypothermia. N Engl J Med 331: 1756–1760

    Article  PubMed  Google Scholar 

  9. Delaney KA, Howland MA, Vassallo S, Goldfrank LR (1989) Assessment of acid-base disturbances and their physiologic consequences. Ann Emerg Med 18(1): 72–82

    Article  PubMed  Google Scholar 

  10. Dobson JA, Burgess JJ (1996) Burgess resuscitation of severe hypothermia by extracorporeal rewarming in a child. J Trauma 40(3): 483–485

    PubMed  Google Scholar 

  11. Gilbert M, Busund R, Skagseth A et al. (2000) Resuscitation from accidental hypothermia of 13.7 degrees C with circulatory arrest. Lancet 355(9201): 375–376

    Article  PubMed  Google Scholar 

  12. Hanania NA, Zimmerman JL (1999) Accidental hypothermia. Crit Care Clin 15: 235–249

    Article  PubMed  Google Scholar 

  13. Hantsch C, Gummin D (2002) Opioids. In: Marx JA (ed) Rosen’s emergency medicine: concepts and clinical practice, 5th edn. Mosby, St. Louis, pp 2183

  14. Hauty MG, Esrig BC, Hill JG, Long WB (1987) Prognostic factors in severe accidental hypothermia. Experience from the Mt. Hood tragedy. J Trauma 27: 1107–1112

    PubMed  Google Scholar 

  15. Jolly BT, Ghezzie KT (1992) Accidental hypothermia. Emerg Med Clin North Am 10: 311–327

    PubMed  Google Scholar 

  16. Koller R, Schnider TW, Neidhart P (1997) Deep accidental hypothermia and cardiac arrest – Rewarming with forced air. Acta Anaesthesiol Scand 41: 1359–1364

    PubMed  Google Scholar 

  17. Kornberger E, Maier P (1996) Important aspects in the treatment of severe accidental hypothermia: the Innsbruck experience. J Neurosurg Anesthesiol 8: 83–87

    PubMed  Google Scholar 

  18. Kroncke GM, Nichols RD, Mendenhall JT et al. (1986) Ectothermic philosophy of acid-base balance to prevent fibrillation during hypothermia. Arch Surg 121(3): 303–304

    PubMed  Google Scholar 

  19. Larach MG (1995) Accidental hypothermia. Lancet 345: 493–498

    Article  PubMed  Google Scholar 

  20. Lazar HL (1997) The treatment of hypothermia. N Engl J Med 337(21): 1545–1547

    Article  PubMed  Google Scholar 

  21. Ledingham IM, Mone JG (1980) Treatment of accidental hypothermia: a prospective clinical study. Br Med J 280: 1102–1105

    PubMed  Google Scholar 

  22. Locher T, Walpoth B, Pfluger D, Althaus U (1991) Akzidentelle Hypothermie in der Schweiz (1980–1987) – Kasuistik und prognostische Faktoren. Schweiz Med Wochenschr 121: 1020–1028

    PubMed  Google Scholar 

  23. Magabarne B, Axler O, Chary I et al. (2000) Hypothermia with indoor occurrence is associated with a worse outcome. Intensive Care Med 26(12): 1843–1849

    Article  PubMed  Google Scholar 

  24. Maier P, Kornberger E, Furtwaengler W et al. (1994) Prognostic markers in patients with severe accidental hypothermia and cardiocirculatory arrest. Resuscitation 27: 47–54

    Article  PubMed  Google Scholar 

  25. Menard MR, Hahn G (1991) Acute and chronic hypothermia in a man with spinal cord injury: environmental and pharmacologic causes. Arch Phys Med Rehabil 72(6): 421–424

    PubMed  Google Scholar 

  26. Röggla M (2002) Severe accidental hypothermia with or without hemodynamic instability: rewarming without use of extracorporal circulation. Wien Klin Wochenschr 114(8–9): 315–320

    Google Scholar 

  27. Saviuc P, Severe F, Danel V (1990) Toxic hypothermias have a better prognosis than accidental hypothermias. Rev Prat Med Gen 94: 45–54

    Google Scholar 

  28. Schaller MD, Fischer AP, Perret CH (1990) Hyperkalemia a prognostic factor during acute severe hypothermia. JAMA 264: 1842–1845

    Google Scholar 

  29. Steinman AM (1986) Cardiopulmonary resuscitation and hypothermia. Circulation 74 [Suppl IV]: IV29–32

  30. Sterz F, Safar P, Tisherman S et al. (1991) Mild hypothermic cardiopulmonary resuscitation improves outcome after prolonged cardiac arrest in dogs. Crit Care Med 19: 379–389

    PubMed  Google Scholar 

  31. Urschel JD (1990) Frostbite: predisposing factors and predictors of poor outcome. J Trauma 30: 340–342

    PubMed  Google Scholar 

  32. Vassal T (2001) Severe accidental hypothermia treated in an ICU. Chest120: 1998–2003

  33. Walpoth BH, Walpoth-Aslan BN, Mattle HP et al. (1997). Outcome of survivors of accidental deep hypothermia and circulatory arrest treated with extracorporal blood warming. N Engl J Med 337(21): 1500–1506

    Article  PubMed  Google Scholar 

  34. Wolf L, Smeeks F, Polocastro M (2001) Oral hypoglycemic agents. In: Ford M, Delaney KA, Ling L, Erickson T (eds) Clinical toxicology, 1st edn. Elsevier, Philadelphia, pp 425

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  1. Abteilung für Anästhesiologie und Intensivmedizin, Landeskrankenhaus, St. Veiterstraße 47, 9020, Klagenfurt, Österreich

    M. Platzer, E. Trampitsch, R. Likar, C. Breschan & H.-V. Schalk

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  1. M. Platzer
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  2. E. Trampitsch
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  3. R. Likar
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  4. C. Breschan
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  5. H.-V. Schalk
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Correspondence to M. Platzer.

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Platzer, M., Trampitsch, E., Likar, R. et al. Kardiopulmonale Reanimation nach Heroinintoxikation und Hypothermie. Anaesthesist 56, 141–144 (2007). https://doi.org/10.1007/s00101-006-1116-2

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  • DOI: https://doi.org/10.1007/s00101-006-1116-2

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