Successful use of mild therapeutic hypothermia as compassionate treatment for severe refractory hypoxemia in COVID-19
Date
2019
Type:
Article
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Abstract
Background: COVID-19 is a disease associated with an intense systemic inflammation that could induce severe acute respiratory distress syndrome (ARDS), with life-threatening
hypoxia and hypercapnia. We present a case where mild therapeutic hypothermia was
associated with improved gas exchange, facing other therapies' unavailability due to the
pandemic.
Case report: A healthy 38-year-old male admitted for COVID-19 pneumonia developed
extreme hypoxia (PaO2/FiO2 ratio 42 mmHg), respiratory acidosis, and hyperthermia,
refractory to usual treatment (mechanical ventilation, neuromuscular blockade, and prone
position), and advanced therapies were not available. Mild therapeutic hypothermia
management (target 33-34°C) was maintained for five days, with progressive gas exchange improvement, which allowed his recovery over the following weeks. He was discharged home after 68 days without significant ICU associated morbidity.
Conclusions: Mild hypothermia is a widely available therapy, that given some specific
characteristics of COVID-19, may be explored as adjunctive therapy for life-threatening
ARDS, especially during a shortage of other rescue therapies.
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Citation
P. Cruces, C. Cores, D. Casanova, et al., Successful use of mild therapeutic hypothermia as compassionate treatment for severe refractory hypoxemia in COVID-19, Journal of Critical Care (2019), https://doi.org/10.1016/j.jcrc.2021.01.008
Keywords
COVID-19, Mild hypothermia, Acute respiratory distress syndrome, Hypoxemia