Zafren, Ken, Raimund Lechner, Peter Paal, Hermann Brugger, Giles Peek, and Tomasz Darocha. Induced hypothermia to as cold as 3°C in humans: Forgotten cases rediscovered. High Alt Med Biol. 22:000–000, 2021.
The lowest temperature from which humans can be successfully rewarmed from accidental hypothermia is unknown. The lowest published core temperature with survival from accidental hypothermia is 11.8°C. We recently reported a rediscovered case series of patients in whom profound hypothermia was induced for surgery. The patient in this case series with the lowest core temperature, 4.2°C, survived neurologically intact. We subsequently rediscovered several additional case series of induced hypothermia to core temperatures below 11.8°C. In one case series, at least one patient was cooled to 3°C. We do not know if any patient survived cooling to 3°C. As in the previous case series, the authors of the additional reports presented physiological data at various core temperatures, showing wide variations in individual responses to hypothermia. These data add to our understanding of the physiology of profound hypothermia. Although induced hypothermia for surgery differs from accidental hypothermia, survival from very low temperatures in induced hypothermia provides evidence that humans with accidental hypothermia can be resuscitated successfully from temperatures much lower than 11.8°C. We continue to advise against using core temperature alone to decide if a hypothermic patient in cardiac arrest has a chance of survival.