The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia—Systematic Review of the Literature

Konrad Mendrala, Sylweriusz Kosiński, Paweł Podsiadło, Mathieu Pasquier, Peter Paal, Piotr Mazur and Tomasz Darocha
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Konrad Mendrala: Department of Anesthesiology and Intensive Care, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland
Sylweriusz Kosiński: Faculty of Health Sciences, Jagiellonian University Medical College, Michalowskiego 12, 31-126 Krakow, Poland
Paweł Podsiadło: Institute of Medical Sciences, Jan Kochanowski University, Al. IX Wiekow Kielc 19A, 25-317 Kielce, Poland
Mathieu Pasquier: Emergency Department, Lausanne University Hospital, University of Lausanne, BH 09, CHUV, 1011 Lausanne, Switzerland
Peter Paal: Department of Anesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Kajetanerplatz 1, 5020 Salzburg, Austria
Piotr Mazur: Department of Cardiovascular Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55902, USA
Tomasz Darocha: Department of Anesthesiology and Intensive Care, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland

IJERPH, 2021, vol. 18, issue 18, 1-11

Abstract: Background: Renal replacement therapy (RRT) can be used to rewarm patients in deep hypothermia. However, there is still no clear evidence for the effectiveness of RRT in this group of patients. This systematic review aims to summarize the rewarming rates during RRT in patients in severe hypothermia, below or equal to 32 °C. Methods: This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (identifier CRD42021232821). We searched Embase, Medline, and Cochrane databases using the keywords hypothermia, renal replacement therapy, hemodialysis, hemofiltration, hemodiafiltration, and their abbreviations. The search included only articles in English with no time limit, up until 30 June 2021. Results: From the 795 revised articles, 18 studies including 21 patients, were selected for the final assessment and data extraction. The mean rate of rewarming calculated for all studies combined was 1.9 °C/h (95% CI 1.5–2.3) and did not differ between continuous (2.0 °C/h; 95% CI 0.9–3.0) and intermittent (1.9 °C/h; 95% CI 1.5–2.3) methods ( p > 0.9). Conclusions: Based on the reviewed literature, it is currently not possible to provide high-quality recommendations for RRT use in specific groups of patients in accidental hypothermia. While RRT appears to be a viable rewarming strategy, the choice of rewarming method should always be determined by the specific clinical circumstances, the available resources, and the current resuscitation guidelines.

Keywords: renal replacement therapy; hypothermia; rewarming (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:18:p:9638-:d:634541

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