RESUMO
OBJECTIVE: To report outcome and intensive care strategy in a 7-year-old girl with accidental profound hypothermia and drowning. DATA SOURCES AND EXTRACTION: Patient records and interviews with search-and-rescue personnel. STUDY SELECTION: Case report. DATA SYNTHESIS: The girl was rescued after an estimated submersion time of at least 83 minutes in icy sea water. She presented with cardiac arrest, ice in her upper airways, a first-documented nasopharyngeal temperature of 13.8°C, and a serum potassium of 11.3 mmol/L. The patient was slowly rewarmed with extracorporeal membrane oxygenation and made an exceptional recovery after intensive care and a long rehabilitation time. CONCLUSION: Excellent outcome is possible in children with body temperature and serum potassium reaching the far limits of previously reported human survival and prolonged submersion time.