Successful Resuscitation of a Severely Hypothermic Neonate☆,☆☆,★
Section snippets
INTRODUCTION
Severe hypothermia is defined as a core body temperature below 28°C.1 We report the treatment of severe hypothermia in a 5-hour-old neonate with subsequent full recovery.
CASE REPORT
Approximately five hours, 20 minutes before arrival in the emergency department, a baby girl was born by normal spontaneous vaginal delivery. The estimated gestational age was 37 weeks. Allegedly, one hour after birth (4 hours, 20 minutes before arrival), the infant was wrapped in a towel, put in a plastic garbage bag, and placed inside the freezer compartment of a refrigerator. Approximately five hours after birth (20 minutes before arrival), paramedics removed the infant from the freezer.
DISCUSSION
Hypothermia is defined as a core body temperature of less than 35°C. Hypothermia has been categorized into three physiologic stages: mild, moderate, and severe. Mild hypothermia refers to core body temperatures between 32° and 35°C. Typical physiologic characteristics include normal blood pressure, shivering, apathy, and dysarthria. Moderate hypothermia refers to core body temperatures between 27° and 32°C. Patients with this degree of hypothermia typically demonstrate progressive decrease in
SUMMARY
We report the successful resuscitation of a severely hypothermic 5-hour-old infant in cardiac arrest who had been found in a freezer. Using a combination of active external and core rewarming techniques, the infant's temperature rose from 16.2°C to 30.5°C in three hours (4.8°C/hr). At time of discharge from the hospital and on subsequent follow-up, the infant was neurologically normal.
This case report supports prior recommendations that hypothermic infants in cardiac arrest should be rewarmed
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Cited by (27)
Unrecognized platelet physiology is the cause of rewarming deaths in accidental hypothermia and neonatal cold injury
2021, Medical HypothesesCitation Excerpt :One example of an excellent outcome after short period of hypothermia even with cardiac arrest is the boating accident in a Norwegian Fjord [29] (see above). There are many such cases reported in neonatal cold injury , such as the neonate who was buried alive and dug up by a passing dog [8] the lifeless 20 month old infant found after 30 min submerged in a 1.1 °C creek [30] the lifeless infant found lying in a clogged city sewer with a skin temperature of 25 °C [31] and the 5 h old neonate in cardiac arrest with a rectal temperature of 16.2 °C found in a garbage bag inside a freezer [27]. All survived after a relatively short period of hyperthermia.
Management of severe accidental hypothermia
2012, Medicina IntensivaAccidental Hypothermia
2011, Pediatric Critical Care: Expert Consult Premium EditionAccidental Hypothermia
2011, Pediatric Critical CareHypothermia
2008, Pediatric Emergency MedicineHypothermia
2007, Pediatric Emergency Medicine
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From the Emergency Department, MacNeal Hospital, Berwyn, Illinois.
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Address for reprints: David A Thompson, MD, FACEP, Emergency Department, 3249 South Oak Park Avenue, MacNeal Hospital, Berwyn, Illinois 60402
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Reprint no. 47/1/55631