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VOLUME 25 , ISSUE 5 ( May, 2021 ) > List of Articles

CASE REPORT

Severe Aortic Thrombosis and Profound Hypothermia: A Case Report

Johan Schmitt, Pierre Esnault, Milena Sartre, Pierre J Cungi, Eric Meaudre

Citation Information : Schmitt J, Esnault P, Sartre M, Cungi PJ, Meaudre E. Severe Aortic Thrombosis and Profound Hypothermia: A Case Report. Indian J Crit Care Med 2021; 25 (5):588-589.

DOI: 10.5005/jp-journals-10071-23820

License: CC BY-NC 4.0

Published Online: 01-05-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Background: Blood clot formation is a multifactorial process and has been related many times in intensive care units. Here is presented a multiple thrombosis formation in a rewarming patient. Case description: A 68-year-old patient was admitted to our intensive care unit after lying on the floor for an unknown time. She presented a severe hypothermia at 26° and a severe cardiogenic shock. Because she was confused and was hypoxemic, she had been intubated at her admission. After intravascular warming, we could stop sedative medications. She presented a right hemiparesis and acute left leg ischemia. Computed tomography (CT) scan revealed a constituted left Sylvian stroke and a massive clot along the aorta. She required a surgical embolectomy and fasciotomy. She died after she presented a severe bowel ischemia on the third day after her admission. Conclusion: Relevant hypothesis for blood clot formation in this patient may include prolonged lying position or blood temperature variation. Hypothermia and rewarming responsibilities may explain multiple thrombosis development.


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  1. Boddi M, Peris A. Deep vein thrombosis in intensive care. Adv Exp Med Biol 2017;906:167–181. DOI: 10.1007/5584_2016_114.
  2. Leone M, Bechis C, Lefrant JY. Outcome of acute mesenteric ischemia in the intensive care unit: a retrospective, multicenter study of 780 cases. Intensive Care Med 2015;41(4):667–676. DOI: 10.1007/s00134-015-3690-8.
  3. Warkentin TE. Microvascular thrombosis and ischaemic limb losses in critically ill patients. Hamostaseologie 2019;39(1):6–19. DOI: 10.1055/s-0038-1676823.
  4. Kushner A, West WP, Pillarisett LS. StatPearls. Treasure Island: StatPearls Publishing; 2019.
  5. Mahajan SL, Myers TJ, Baldini MG. Disseminated intravascular coagulation during rewarming following hypothermia. JAMA 1981;245:2517–2518. DOI: 10.1001/jama.1981.03310490035022.
  6. Spero JA, Lewis JH, Hasiba U. Disseminated intravascular coagulation: findings in 346 patients. Thromb Haemost 1980;43:28–33. PMID: 6773170.
  7. Sands M, Mohri H, Shigekazu S, Mannik M, Hessel E, Dillard D. Hematorheology during deep hypothermia. Cryobiology 1979;16:229–239. DOI: 10.1016/0011-2240(79)90036-1.
  8. Hynson JM, Sesslet DI, Moayeri A, McGuire J. Absence of nonshivering thermogenesis in anesthetized humans. Anesthesiology 1993;79:695–703. DOI: 10.1097/00000542-199310000-00010.
  9. Han YS, Tveita T, Prakash YS, Sieck G. Mechanisms underlying hypothermia-induced cardiac contractile dysfunction. Am J Physiol Heart Circ Physiol 2009;298:890–897. DOI: 10.1152/ajpheart.00805.2009.
  10. Mallet ML. Pathophysiology of accidental hypothermia. Q J Med 2002;95:775–785. DOI: 10.1093/qjmed/95.12.775.
  11. Mikhailidis DP, Hutton RA, Jeremy JY, Dandona P. Hypothermia and pancreatitis. J Clin Pathol 1983;36:483–484. DOI: 10.1136/jcp.36.4.483.
  12. Martin-Du Pan RC, Benoit R, Girardier L. The role of body position and gravity in the symptoms and treatment of various medical diseases. Swiss Med Wkly 2004;134(37-38):543–551. DOI: 10.4414/smw.2004.09765.
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