Subject(s)
Humans , Extracorporeal Membrane Oxygenation , Hypothermia/etiology , Hypothermia/therapy , RewarmingSubject(s)
Extracorporeal Membrane Oxygenation , Hypothermia , Humans , Hypothermia/therapy , Switzerland , RewarmingSubject(s)
COVID-19/complications , Hypoxia-Inducible Factor 1/metabolism , Hypoxia/metabolism , Pulmonary Arterial Hypertension/etiology , SARS-CoV-2 , Altitude , Altitude Sickness/metabolism , COVID-19/epidemiology , Health Care Surveys , Humans , Nitric Oxide/metabolism , Polycythemia/etiology , Publishing/standards , Pulmonary Arterial Hypertension/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , SARS-CoV-2/physiology , Virus ReplicationABSTRACT
A narrative review is presented on the diagnosis, treatment and management of accidental hypothermia. Although all these processes form a continuum, for descriptive purposes in this manuscript the recommendations are organized into the prehospital and in-hospital settings. At prehospital level, it is advised to: a) perform high-quality cardiopulmonary resuscitation for cardiac arrest patients, regardless of body temperature; b) establish measures to minimize further cooling; c) initiate rewarming; d) prevent rescue collapse and continued cooling (afterdrop); and (e) select the appropriate hospital based on the clinical and hemodynamic situation of the patient. Extracorporeal life support has revolutionized rewarming of the hemodynamically unstable victim or patients suffering cardiac arrest, with survival rates of up to 100%. The new evidences indicate that the management of accidental hypothermia has evolved favorably, with substantial improvement of the final outcomes.
Subject(s)
Cardiopulmonary Resuscitation/methods , Emergency Medical Services , Hypothermia/therapy , Out-of-Hospital Cardiac Arrest/therapy , Rewarming/methods , Avalanches , Biomarkers/blood , Body Temperature , Cardiopulmonary Resuscitation/standards , Cold Temperature/adverse effects , Electric Countershock , Extracorporeal Membrane Oxygenation/methods , Fluid Therapy/methods , Hospitalization , Humans , Hypothermia/complications , Hypothermia/diagnosis , Immersion/adverse effects , Oxygen Consumption , Potassium/bloodABSTRACT
High altitude sickness (hypobaric hypoxia) is a form of cellular hypoxia similar to that suffered by critically ill patients. The study of mountaineers exposed to extreme hypoxia offers the advantage of involving a relatively homogeneous and healthy population compared to those typically found in Intensive Care Units (ICUs), which are heterogeneous and generally less healthy. Knowledge of altitude physiology and pathology allows us to understanding how hypoxia affects critical patients. Comparable changes in mitochondrial biogenesis between both groups may reflect similar adaptive responses and suggest therapeutic interventions based on the protection or stimulation of such mitochondrial biogenesis. Predominance of the homozygous insertion (II) allele of the angiotensin-converting enzyme gene is present in both individuals who perform successful ascensions without oxygen above 8000 m and in critical patients who overcome certain disease conditions.
Subject(s)
Altitude Sickness/physiopathology , Critical Illness/therapy , Cell Hypoxia , Humans , Hypoxia-Inducible Factor 1/physiologyABSTRACT
Acute respiratory failure secondary to Coxiella burnetii infection is an extremely rare but serious complication that usually has a good prognosis after appropriate treatment. We describe a female patient who developed acute respiratory failure secondary to Coxiella burnetii pneumonia requiring mechanical ventilation and antibiotic therapy.
