A case of severe hypothermia with acute suppurative cholangitis resulting in bradycardia and cardiac arrest during rewarming

DOI
  • Ikeda Mayuko
    Tokyo Women's Medical University Yachiyo Medical Center, Emergency and Critical Care Medicine
  • Hirose Yosuke
    Chibaken Saiseikai Narashino Hospital, Emergency Department
  • Yuzawa Hiroko
    Tokyo Women's Medical University Yachiyo Medical Center, Emergency and Critical Care Medicine
  • Kondo Kengo
    Tokyo Women's Medical University Yachiyo Medical Center, Emergency and Critical Care Medicine
  • Hosono Kazuki
    Tokyo Women's Medical University Yachiyo Medical Center, Emergency and Critical Care Medicine
  • Sadahiro Tomohito
    Tokyo Women's Medical University Yachiyo Medical Center, Emergency and Critical Care Medicine

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Other Title
  • 高度低体温症で来院し, 復温の過程で徐脈から心静止に至った急性化膿性胆管炎の1例

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Abstract

<p>A 74-year-old man with severe hypothermia complicated by septic shock due to acute suppurative cholangitis was admitted to our hospital in an unconscious state. On admission, his rectal temperature was 26.7 ℃, systolic blood pressure was 57 mmHg and ECG showed sinus bradycardia at 49 beats/min. Large volumes of warm intravenous fluid were administered, but the patient went into cardiac arrest twice during warming. Cardiopulmonary resuscitation was promptly performed, and spontaneous circulation was restored twice. Hypothermia, especially in the elderly, should be treated urgently by suspecting infection and investigating the cause as well as restoring body temperature. In addition, during the treatment of hypothermia, it is necessary to keep in mind that not only VT/VF but also cardiac arrest may occur during warming.</p>

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