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Table 2 The most extreme reported accidental hypothermia cases

From: Accidental hypothermia–an update

Longest no flow time 42-year-old male, found in crevasse, 7 m under snow, no vital signs, CPR started only after 70 min in hospital when patient was asystolic, 19 °C core temperature, ECLS rewarming, full recovery [211].
Longest manual CPR 42-year-old male, found outdoors. Developed asystole just after discovery, CPR started, 23.2 °C, 6 h and 30 min CPR. Rewarmed with non-ECLS methods until ROSC. Full recovery [143].
Longest mechanical CPR 42-year-old female, found unconscious in her apartment. VF arrest during evacuation to hospital. Manual CPR started and this was changed to mechanical CPR on arrival at hospital. Minimal temperature 24 °C. 80 min mechanical CPR while the patient was rewarmed noninvasively [153].
Longest total resuscitation 65-year-old female went missing and was found on a snow-covered riverbank. Initially 28 °C (rectal) but dropped to 20.8 °C. Asystole. Resuscitation was CPR (4 h 48 m) and ECLS (3 h 52 m). Total resuscitation time was 8 h 40 min [142].
Lowest survived body core temperature 29-year-old female, fell into water fall gully, flooded by icy water but able to breathe. Lifeless for approx. 45 min, CPR started after rescue, at hospital admission 13.7 °C and K+ of 4.3 mmol L-1, ECLS rewarming, full recovery [11].
Longest persisting VF 42-year-old male, found outdoor, CPR started, repeated shocks, hospital transfer, 22 °C, ECLS rewarming started at 130 min CPR and after 38 shocks, successful shock at 30 °C, full recovery [234].
25-year-old female, buried by and avalanche in Tatra mountains, Poland. Witnessed VF cardiac arrest (17.0 °C) after extrication, 3 unsuccessful shocks. CPR until ECMO rewarming (6 h, 45 min), and successful 4th shock at 24.8 °C. Full recovery [235].
Longest intermittent CPR 57-year-old female, witnessed cardiac arrest in French Alps at 2000 m altitude in a snowstorm; transport distance to EMS vehicle of 1.1 km, 122 m difference in height; 1 min CPR alternating with 1 min walking for 25 min, 5 h CPR, ECLS rewarming, full recovery [69].
Longest submersion 2.5-year-old, submersion in cold water for at least 66 min, 19 °C, ECLS rewarming, full recovery [38]. 7-year-old child, submersion in icy water for at least 83 min, CPR for 64 min, 13.8 °C, K+ 11.3 mmol L-1, ECLS rewarming, full recovery [212].
Longest survival in an avalanche Female, core temperature <32 °C, when found somnolent, disorientated. 1st- 2nd degree frost bites on hand and feet, no injuries, 43 h and 45 min [236, 237].
Longest time in an avalanche indoor Thirteen days entrapped in a house which in part collapsed after being hit by an avalanche, Heiligenblut, Austria [238].
Lowest temperature with vital signs Male age 3 years. ECG showed very irregular rhythm 8–10/min. Rectal temperature recorded about 20 min after arrival at the hospital was 17 °C [232].
Female age 37 years. Rectal temperature 17.2 °C. ECG showed atrial fibrillation 28–40/min with PVCs [233].
Highest survived potassium in an avalanche victim Avalanche victim, 6.4 mmol L-1, survived; core temperature and neurological outcome are not reported [130].
Highest survived potassium in an adult 34 year old female, 20 °C, cold environment exposure, asystole, 7.9 mmol L-1, ECLS rewarming, survived. Neurologic outcome not reported [239].
Highest potassium in an accidentally hypothermic patient 7 -year-old and, cold water submersion, 11.3 mmol L-1 [212], and 31 month old child, cold water submersion, 11.7 mmol L-1 [131].
Longest time in a crevasse 27 -year-old male, 8 days, good outcome, no temperature or other specific details reported [240]
70 year male, moderate fractures of skull, vertebral column, pelvis, and femur, 6 days, 33.5 °C, cold injuries to toes, otherwise good outcome [241].
Largest number of simultaneous cases of accidental hypothermia with cardiac arrest 15 healthy subjects age 15–45 years were immersed in 2 °C salt water. Seven victims were recovered in circulatory arrest with a median temperature of 18.4 °C. They were rewarmed with ECMO and were subsequently evaluated with advanced neuroradiological and functional testing. All were successfully resuscitated [41].