TY  - JOUR
PY  - 2012//
TI  - Respiratory Failure and Spontaneous Hypoglycemia During Noninvasive Rewarming From 24.7°C (76.5°F) Core Body Temperature After Prolonged Avalanche Burial
JO  - Annals of emergency medicine
A1  - Strapazzon, Giacomo
A1  - Nardin, Michele
A1  - Zanon, Peter
A1  - Kaufmann, Marc
A1  - Kritzinger, Meinhard
A1  - Brugger, Hermann
SP  - 193
EP  - 196
VL  - 60
IS  - 2
N2  - Clinical reports on management and rewarming complications after prolonged avalanche burial are not common. We present a case of an unreported combination of respiratory failure and unexpected spontaneous hypoglycemia during noninvasive rewarming from severe hypothermia. We collected anecdotal observations in a 42-year-old, previously healthy, male backcountry skier admitted to the ICU at a tertiary care center after 2 hours 7 minutes of complete avalanche burial, who presented with a patent airway and a core body temperature of 25.0°C (77.0°F) on extrication. There was no decrease in core body temperature during transport (from 25.0°C [77.0°F] to 24.7°C [76.5°F]). Atrial fibrillation occurred during active noninvasive external rewarming (to 37.0°C [98.6°F] during 5 hours), followed by pulmonary edema and respiratory failure (SaO(2) 73% and PaO(2)/FIO(2) 161 mm Hg), which resolved with endotracheal intubation and continuous positive end-respiratory pressure. Moreover, a marked spontaneous glycemic imbalance (from 22.2 to 1.4 mmol/L) was observed. Despite a possible favorable outcome, clinicians should be prepared to identify and treat severe respiratory problems and spontaneous hypoglycemia during noninvasive rewarming of severely hypothermic avalanche victims.<p /> <p>Language: en</p>
LA  - en
SN  - 0196-0644
UR  - http://dx.doi.org/10.1016/j.annemergmed.2011.11.015
ID  - ref1
ER  -