Implication of a new algorithm for treatment of accidental deep hypothermia victims and the need for a hypothermia registry

Background: Transient mild hypothermia is common and usually without consequences for the brain or other organs. However, prolonged deep hypothermia due to accidents is rare and usually associated with premature death.

Material and Methods: Few people survive and can be resuscitated with appropriate means. The degree of hypothermia, the exposure time and type of accident may vary but long-term survival rates without sequellae of 47% have been reported. Previous reports have been based mainly on case reports with successful therapy of survival patients whereas the negative outcomes have not been reported. Larger epidemiologic studies have proposed outcome score models for facilitating triage and decision making. In addition we propose a new algorithm for the resuscitation of hypothermia victims.

Results: In an effort to gain more information on the severity of sequellae and outcome of deep hypothermia victims, we have started an international registry. The data of this registry is collected worldwide using the internet as a common database for entry and retrieval of the accumulated scientific data. The registry gathers important information on body temperature, exposure time, type of accident, environmental factors and concomitant injuries. In addition, rescue modalities, prehospital treatment, hospital rewarming methods and patients’ outcome data are included. The registry is directed by an international working group.

Conclusions: The proposed recommendations and algorithms should improve decision making and treatment of victims in deep hypothermia and cardio-respiratory arrest. This international register for issuing guidelines on prevention, diagnosis and resuscitation of accidental deep hypothermia victims is desirable has now been created.