The ideal rewarming technique should be determined on a case-by-case basis; the most expensive methods may not always be indicated. While it is generally accepted that CPB is the ideal method of rewarming for patients in cardiac arrest, this is not always available. If this is not available and transfer is not possible due to prolonged transport times to the closest CPB center or the severity of the patient’s condition, other methods should be used, including thoracic cavity lavage, peritoneal lavage, or other active internal rewarming techniques. Elderly patients with multiple comorbidities may not be able to tolerate more-invasive therapies for accidental hypothermia. In these patients, less aggressive and, often, less costly therapies may be indicated.
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