BACKGROUND: The optimal rewarming technique for @entity1 in deep @entity2332 with core temperatures below 28 degrees C is not established. Several authors believe that extracorporeal rewarming is essential, especially for @entity1 with @entity1344 . Others believe that invasive rewarming ought to be reserved for @entity1 in @entity1167 . We describe our experience with a strictly conservative technique without the use of invasive rewarming devices in @entity1 with severe @entity2332 and a sustained perfusion rhythm. METHODS: A cohort study extending from 1991 to 2000, including all @entity1 received at the emergency department of the University Hospital of Vienna with severe @entity2332 , a core temperature of maximum 28 degrees C and no preclinical @entity1167 . RESULTS: 36 @entity1 with @entity2332 were included in the study. Their core temperatures ranged from 20.2 degrees C to 28 degrees C; the median temperature was 25.75 degrees C (25th and 75th percentile, 24.2/27.3). Fourteen @entity1 were intoxicated and their multimorbidity was high. All of 19 @entity1 with stable hemodynamics and 14 of 17 @entity1 with unstable hemodynamics were successfully rewarmed to normothermia with warmed infusions, inhalation rewarming and forced air rewarming. The rewarming process took 9.5 hours (8/10.5) and required a volume load of 4820 ml (2735/5770). The rewarming rate was 1.09 degrees C per hour (0.94/1.25). Although 92% of the @entity1 were successfully rewarmed to normothermia, in-hospital mortality was 42%, but was largely related to comorbidity. DISCUSSION: A conservative approach is highly successful in achieving normothermia in @entity1 with @entity2332 with or without stable hemodynamics. In-hospital mortality of severe @entity2332 in urban conditions is high; comorbidity might play a major role. The influence of the rewarming strategy on late in-hospital mortality remains unclear.

Severe XXXX with or without @entity1344 : rewarming without the use of extracorporeal circulation.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['cardiac arrest'] @entity2332 :: ('MESH:D007035', 'Disease') :: ['accidental hypothermia', 'deep hypothermia', 'hypothermia'] @entity1344 :: ('MESH:D043171', 'Disease') :: ['hemodynamic instability']
@entity2332 :: (MESH:D007035,Disease) :: ['accidental hypothermia']
