The Use of Veno-Arterial Extracorporeal Membrane Oxygenation System for Refractory Circulatory Arrest Due to Accidental Hypothermia: a Clinical Case Report

Thermal injuries caused by external cold exposure remain one of the most significant multidisciplinary challenges in critical care medicine. In cases of refractory circulatory arrest resulting from hypothermia, the use of circulatory support methods, particularly the veno-arterial extracorporeal membrane oxygenation (VA ECMO) system, becomes specially grounded and desirable.

Objective. To demonstrate the successful use of veno-arterial ECMO in a patient with severe accidental hypothermia complicated by refractory circulatory arrest during the prehospital phase.

Materials and Methods. We present the clinical case of a 42-year-old patient with severe generalized hypothermia (temperature 20.0°C), marked hemodynamic instability, and subsequent development of refractory ventricular fibrillation. Given the ineffectiveness of standard resuscitation measures during the prehospital phase, we initiated VA ECMO followed by extracorporeal rewarming and comprehensive intensive care.

Results. Following initiation of VA ECMO and controlled warming, restoration of cardiac rhythm and cardiorespiratory function was achieved. Weaning from VA ECMO was performed on the third day, and from respiratory support within the first two days of the hospital stay. On the 22^nd day, the patient was discharged in a stable somatic condition without significant neurological deficits.

 Conclusion. Early prehospital initiation of VA ECMO as a part of comprehensive intensive care may represent an effective treatment option for severe accidental hypothermia complicated by refractory circulatory arrest.

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