Resuscitation
Volume 81, Issue 6 , Pages 645-652 , June 2010

Prognostic factors in avalanche resuscitation: A systematic review

  • Jeff Boyd

      Affiliations

    • Department of Emergency Medicine, Mineral Springs Hospital, Banff, AB, Canada
    • International Federation of Mountain Guides, Banff, Alberta, Canada
    • Corresponding Author InformationCorresponding author at: Department of Emergency Medicine, Mineral Springs Hospital, Banff, AB, Canada. Tel.: +1 403 762 4974; fax: +1 403 762 4193.
  • ,
  • Hermann Brugger

      Affiliations

    • EURAC Institute of Mountain Emergency Medicine, Bozen/Bolzano, Italy
    • Innsbruck Medical University, Innsbruck, Austria
  • ,
  • Michael Shuster

      Affiliations

    • Department of Emergency Medicine, Mineral Springs Hospital, Banff, AB, Canada

Received 30 November 2009 ,Revised 12 January 2010 ,Accepted 18 January 2010.

References 

  1. Harvey S, Signorell C, Genswein M . Avalanche accidents in back country terrain of the Swiss Alps: new investigations of a 30 year database. In:  Campbell C,  Conger S editor. International Snow Science Workshop 2002: Proceedings of international snow science workshop. ISSW 2002 Committee, Penticton, Canada, 29 September–4 October. 2002;Accessed 23 October 2009, at http://www.avalanche.org/∼issw2004/issw_previous/2002/flashsite/Rescue_and_Survival/Harvey%20poster1%20revision.html.
  2. Boyd J, Haegeli P, Abu-Laban RB, Shuster M, Butt JC. Patterns of death among avalanche fatalities: a 21-year review. CMAJ. 2009;180:507–512
  3. Brugger H, Etter HJ, Boyd J, Falk M. Causes of death from avalanche. Wilderness Environ Med. 2009;20:93–96
  4. Hohlrieder M, Brugger H, Schubert HM, Pavlic M, Ellerton J, Mair P. Pattern and severity of injury in avalanche victims. High Alt Med Biol. 2007;8:56–61
  5. McIntosh SE, Grissom CK, Olivares CR, Kim HS, Tremper B. Cause of death in avalanche fatalities. Wilderness Environ Med. 2007;18:293–297
  6. Harvey S, Zweifel B . New trends of recreational avalanche accidents in Switzerland. In:  Campbell C,  Conger S editor. International Snow Science Workshop 2008: Proceedings of international snow science workshop. ISSW 2008 Committee, Whistler, Canada, 21–27 September. 2008;Accessed 23 October 2009, at http://www.slf.ch/praevention/lawinenunfaelle/unfallstatistik/paper_issw08.pdf.
  7. Mair P, Kornberger E, Furtwaengler W, Balogh D, Antretter H. Prognostic markers in patients with severe accidental hypothermia and cardiocirculatory arrest. Resuscitation. 1994;27:47–54
  8. Oberhammer R, Beikircher W, Hormann C, et al. Full recovery of an avalanche victim with profound hypothermia and prolonged cardiac arrest treated by extracorporeal re-warming. Resuscitation. 2008;76:474–480
  9. Locher T, Walpoth B, Pfluger D, Althaus U. Accidental hypothermia in Switzerland (1980–1987)—case reports and prognostic factors. Schweiz Med Wochenschr. 1991;121:1020–1028
  10. Schaller MD, Fischer AP, Perret CH. Hyperkalemia. A prognostic factor during acute severe hypothermia. JAMA. 1990;264:1842–1845
  11. Brugger H, Durrer B, Adler-Kastner L. On-site triage of avalanche victims with asystole by the emergency doctor. Resuscitation. 1996;31:11–16
  12. Hohlrieder M, Mair P, Wuertl W, Brugger H. The impact of avalanche transceivers on mortality from avalanche accidents. High Alt Med Biol. 2005;6:72–77
  13. Brugger H, Durrer B, Adler-Kastner L, Falk M, Tschirky F. Field management of avalanche victims. Resuscitation. 2001;51:7–15
  14. Ruttmann E, Weissenbacher A, Ulmer H, et al. Prolonged extracorporeal membrane oxygenation-assisted support provides improved survival in hypothermic patients with cardiocirculatory arrest. J Thorac Cardiovasc Surg. 2007;134:594–600
  15. Sumann G. Pre-hospital triage and therapy of avalanche victims. Intensivmedizin. 2002;39:315–320
  16. Morley PT. Evidence evaluation worksheets: the systematic reviews for the evidence evaluation process for the 2010 International Consensus on Resuscitation Science. Resuscitation. 2009;80:719–721
  17. International Liaison Committee on Resuscitation. Defining Quality of Evidence.doc. Accessed 26 October 2009, at http://www.mc.manuscriptcentral.com:80/societyimages/ilcor/Defining%20Quality%20of%20Evidence.doc.
  18. Brugger H, Falk M. New perspectives of avalanche disasters. Phase classification using pathophysiologic considerations. Wien Klin Wochenschr. 1992;104:167–173
  19. Kornberger E, Mair P. Important aspects in the treatment of severe accidental hypothermia: the Innsbruck experience. J Neurosurg Anesthesiol. 1996;8:83–87
  20. Brugger H, Sumann G, Meister R, et al. Hypoxia and hypercapnia during respiration into an artificial air pocket in snow: implications for avalanche survival. Resuscitation. 2003;58:81–88
  21. Burtscher M. Avalanche survival chances. Nature. 1994;371:482
  22. Buser O, Etter HJ, Jaccard C. Probability of dying in an avalanche. Z Unfallchir Versicherungsmed. 1993;(Suppl. 1):263–271
  23. Falk M, Brugger H, Adler-Kastner L. Avalanche survival chances. Nature. 1994;368:21
  24. Locher T, Walpoth BH. Differential diagnosis of circulatory failure in hypothermic avalanche victims: retrospective analysis of 32 avalanche accidents. Schweiz Rundsch Med Prax. 1996;85:1275–1282
  25. Grosse AB, Grosse CA, Steinbach LS, Zimmermann H, Anderson S. Imaging findings of avalanche victims. Skeletal Radiol. 2007;36:515–521
  26. Grissom CK, Radwin MI, Harmston CH, Hirshberg EL, Crowley TJ. Respiration during snow burial using an artificial air pocket. JAMA. 2000;283:2266–2271
  27. Stalsberg H, Albretsen C, Gilbert M, et al. Mechanism of death in avalanche victims. Virchows Arch A Pathol Anat Histopathol. 1989;414:415–422
  28. Radwin MI, Grissom CK. Technological advances in avalanche survival. Wilderness Environ Med. 2002;13:143–152
  29. Danzl DF, Robert SP, Paul SA, et al. Multicenter hypothermia survey. Ann Emerg Med. 1987;16:1042–1055
  30. Walpoth BH, Walpoth-Aslan BN, Mattle HP, et al. Outcome of survivors of accidental deep hypothermia and circulatory arrest treated with extracorporeal blood warming. N Engl J Med. 1997;337:1500–1505
  31. Althaus U, Aeberhard P, Schupbach P, Nachbur BH, Muhlemann W. Management of profound accidental hypothermia with cardiorespiratory arrest. Ann Surg. 1982;195:492–495
  32. Grissom CK, McAlpine JC, Harmston CH, et al. Hypercapnia effect on core cooling and shivering threshold during snow burial. Aviat Space Environ Med. 2008;79:735–742
  33. Farstad M, Andersen KS, Koller ME, Grong K, Segadal L, Husby P. Rewarming from accidental hypothermia by extracorporeal circulation. A retrospective study. Eur J Cardiothorac Surg. 2001;20:58–64
  34. Grissom CK, Radwin MI, Scholand MB, Harmston CH, Muetterties MC, Bywater TJ. Hypercapnia increases core temperature cooling rate during snow burial. J Appl Physiol. 2004;96:1365–1370
  35. Hauty MG, Esrig BC, Hill JG, Long WB. Prognostic factors in severe accidental hypothermia: experience from the Mt. Hood tragedy. J Trauma. 1987;27:1107–1112
  36. Dobson JA, Burgess JJ. Resuscitation of Severe Hypothermia by Extracorporeal Rewarming in a Child. Journal of Trauma: Inj Infect Crit Care. 1996;40:483–485
  37. von Segesser LK, Garcia E, Turina M. Perfusion without systemic heparinization for rewarming in accidental hypothermia. Ann Thorac Surg. 1991;52:560–561
  38. Bender PR, Debehnke DJ, Swart GL, Hall KN. Serum potassium concentration as a predictor of resuscitation outcome in hypothermic cardiac arrest. Wilderness Environ Med. 1995;6:273–282
  39. Silfvast T, Pettila V. Outcome from severe accidental hypothermia in Southern Finland—a 10-year review. Resuscitation. 2003;59:285–290
  40. Brugger H, Durrer B. On-site treatment of avalanche victims ICAR-MEDCOM-recommendation. High Alt Med Biol. 2002;3:421–425
  41. Paal P, Beikircher W, Brugger H. Avalanche emergencies: review of the current situation. Anaesthesist. 2006;55:314–324
  42. Strohm PC, Kostler W, Hammer T, Sudkamp NP. Avalanche emergency and accidental hypothermia. Unfallchirurg. 2003;106:343–347

 “A Spanish translated version of the abstract of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2010.01.037”.

PII: S0300-9572(10)00136-X

doi: 10.1016/j.resuscitation.2010.01.037

Resuscitation
Volume 81, Issue 6 , Pages 645-652 , June 2010