Hypothermic rescue by veno-arterial extracorporeal membrane oxygenation: A case report

Perfusion. 2023 Aug 7:2676591231194464. doi: 10.1177/02676591231194464. Online ahead of print.

Abstract

Introduction: Severe hypothermia is a life-threatening condition that often causes hemodynamic instability or cardiac arrest and carries a high risk of mortality. The use of VA-ECMO in this indication has greatly improved the prognosis of patients.

Case report: We describe an incredible case involving the complete recovery of a 47-year-old man placed on VA-ECMO for cardiogenic shock and protracted ventricular fibrillation caused by hypothermia. The patient was discharged home in 20 days with no neurologic sequelae.

Clinical discussion: Extracorporeal life support (ECLS) with cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) has been recommended as the gold standard for the treatment of severe hypothermia due to its rapid availability and the possibility of prolonged support. Our case demonstrates the effectiveness of ECMO in treating patients with hypothermic cardiogenic shock. At the same time, nutritional support and rehabilitation therapy play an integral role in the whole treatment process. Therefore, it is recommended that such patients be managed by an experienced cardiac team that can evaluate the patient's condition in multiple aspects.

Conclusion: ECMO may be an effective treatment for hypothermia-induced cardiogenic shock, but further research is needed on the effectiveness of this method of treatment.

Keywords: cardiac arrest; extracorporeal membrane oxygenation; hypothermia; rewarming; ventricular fibrillation.