Successful recovery from accidental profound hypothermia (rectal temperature 22 C [71.6 F] using bloodstream rewarming is described. Circulation and respiration had ceased prior to the initiation of extracorporeal circulation.
Core rewarming is theoretically preferable to surface methods in that the central organs, particularly the heart, are rewarmed in advance of the increasing metabolic demands at the periphery. Precisely the opposite situation is obtained with surface rewarming. Nonetheless, mild accidental hypothermia or more severe degrees in which an effective circulation persists can be managed appropriately by surface rewarming techniques. If the circulation is inadequate when the patient is first seen or should fail during surface rewarming, we would currently regard bloodstream rewarming using peripheral cannulation, a pump-oxygenator, and a heat exchanger as the method of choice.