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Editorial| Volume 164, P142-143, July 2021

Rescue collapse — A hitherto unclassified killer in accidental hypothermia

  • Mathieu Pasquier
    Correspondence
    Corresponding author at: Emergency Department, Lausanne University Hospital, University of Lausanne, BH 06, CHUV, 1011 Lausanne, Switzerland.
    Affiliations
    Department of Emergency Medicine, Lausanne University Hospital and University of Lausanne, BH 09, 1011 Lausanne, Switzerland
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  • Peter Paal
    Affiliations
    Department of Anesthesiology and Intensive Care Medicine, Hospitaller Brothers Hospital, Paracelsus Medical University, Kajetanerplatz 1, 5020 Salzburg, Austria
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Published:May 31, 2021DOI:https://doi.org/10.1016/j.resuscitation.2021.05.011
Rescue collapse — A hitherto unclassified killer in accidental hypothermia
Previous ArticleClosing the Gap: How Telephone Assisted Cardiopulmonary Resuscitation (TA-CPR) Can Aid in Reducing the Sex Disparity in the Provision of Bystander CPR
Next ArticleInvasive neuromonitoring post-cardiac arrest: Key considerations
      Severe accidental hypothermia (<28 °C) is a rare occurrence, it may induce cardiac arrest (CA).
      • Frei C.
      • Darocha T.
      • Debaty G.
      • et al.
      Clinical characteristics and outcomes of witnessed hypothermic cardiac arrest: a systematic review on rescue collapse.
      Resuscitation. 2019; 137: 41-48
      Hypothermia induced CA is fundamentally different from primary CA.
      • Gordon L.
      • Paal P.
      Normothermic and hypothermic cardiac arrest—beware of Jekyll and Hyde.
      Resuscitation. 2018; 129: e10-e11
      The hypothermic heart may be unresponsive to defibrillation and resuscitative drugs.
      • Lott C.
      • Truhlář A.
      • Alfonzo A.
      • et al.
      European Resuscitation Council Guidelines 2021: cardiac arrest in special circumstances.
      Resuscitation. 2021; 161: 152-219
      Extracorporeal life support (ECLS) is the recommended rewarming method for selected arrested hypothermic patients.
      • Lott C.
      • Truhlář A.
      • Alfonzo A.
      • et al.
      European Resuscitation Council Guidelines 2021: cardiac arrest in special circumstances.
      Resuscitation. 2021; 161: 152-219
      , 
      • Ohbe H.
      • Isogai S.
      • Jo T.
      • Matsui H.
      • Fushimi K.
      • Yasunaga H.
      Extracorporeal membrane oxygenation improves outcomes of accidental hypothermia without vital signs: a nationwide observational study.
      Resuscitation. 2019; 144: 27-32
      , 
      • Swol J.
      • Darocha T.
      • Paal P.
      • et al.
      ASAIO J. 2021; (in press)
      Hypothermia reduces the metabolism, thereby protecting the brain in no and low blood-flow states. Outcome of arrested hypothermic compared to normothermic patients is substantially better, even if cardiopulmonary resuscitation (CPR) lasts for several hours.
      • Pasquier M.
      • Hugli O.
      • Paal P.
      • et al.
      Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: the HOPE score.
      Resuscitation. 2018; 126: 58-64
      , 
      • Pasquier M.
      • Rousson V.
      • Darocha T.
      • et al.
      Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: an external validation of the HOPE score.
      Resuscitation. 2019; 139: 321-328
      In hypothermic patients witnessed CA is called rescue collapse (RC).
      • Frei C.
      • Darocha T.
      • Debaty G.
      • et al.
      Clinical characteristics and outcomes of witnessed hypothermic cardiac arrest: a systematic review on rescue collapse.
      Resuscitation. 2019; 137: 41-48
      , 
      • Pasquier M.
      • Debaty G.
      • Carron P.N.
      • Darocha T.
      Reply to: the importance of pre-hospital interventions for prevention and management of witnessed hypothermic cardiac arrest.
      Resuscitation. 2019; 140: 219-220
      Until now, the influence of rescue collapse on survival in hypothermic arrested patients is not determined. Rescue collapse should be avoided, but if it occurs it is considered reversible with early and continuous CPR and ECLS rewarming. In this issue, Podsiadło et al. address the implications of rescue collapse on survival and the course of in-hospital therapy. Moreover, they report risk factors for rescue collapse.
      • Podsiadło P.
      • Smoleń A.
      • Kosiński S.
      • et al.
      Impact of rescue collapse on mortality rate in severe accidental hypothermia: a matched-pair analysis.
      Resuscitation. 2021; 164: 108-113
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      References

        • Frei C.
        • Darocha T.
        • Debaty G.
        • et al.
        Clinical characteristics and outcomes of witnessed hypothermic cardiac arrest: a systematic review on rescue collapse.
        Resuscitation. 2019; 137: 41-48
        View in Article
        • Gordon L.
        • Paal P.
        Normothermic and hypothermic cardiac arrest—beware of Jekyll and Hyde.
        Resuscitation. 2018; 129: e10-e11
        View in Article
        • Lott C.
        • Truhlář A.
        • Alfonzo A.
        • et al.
        European Resuscitation Council Guidelines 2021: cardiac arrest in special circumstances.
        Resuscitation. 2021; 161: 152-219
        View in Article
        • Ohbe H.
        • Isogai S.
        • Jo T.
        • Matsui H.
        • Fushimi K.
        • Yasunaga H.
        Extracorporeal membrane oxygenation improves outcomes of accidental hypothermia without vital signs: a nationwide observational study.
        Resuscitation. 2019; 144: 27-32
        View in Article
        • Swol J.
        • Darocha T.
        • Paal P.
        • et al.
        ASAIO J. 2021; (in press)
        View in Article
        • Pasquier M.
        • Hugli O.
        • Paal P.
        • et al.
        Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: the HOPE score.
        Resuscitation. 2018; 126: 58-64
        View in Article
        • Pasquier M.
        • Rousson V.
        • Darocha T.
        • et al.
        Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: an external validation of the HOPE score.
        Resuscitation. 2019; 139: 321-328
        View in Article
        • Pasquier M.
        • Debaty G.
        • Carron P.N.
        • Darocha T.
        Reply to: the importance of pre-hospital interventions for prevention and management of witnessed hypothermic cardiac arrest.
        Resuscitation. 2019; 140: 219-220
        View in Article
        • Podsiadło P.
        • Smoleń A.
        • Kosiński S.
        • et al.
        Impact of rescue collapse on mortality rate in severe accidental hypothermia: a matched-pair analysis.
        Resuscitation. 2021; 164: 108-113
        View in Article
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        Prognostic factors for nonasphyxia-related cardiac arrest patients undergoing extracorporeal rewarming — HELP registry study.
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        View in Article
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        View in Article
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        View in Article

      Article info

      Publication history

      Published online: May 31, 2021
      Received: May 14, 2021

      Identification

      DOI: https://doi.org/10.1016/j.resuscitation.2021.05.011

      Copyright

      © 2021 Elsevier B.V. All rights reserved.

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