{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:35:35Z","timestamp":1789623335168,"version":"build-2803163510"},"reference-count":32,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["High Altitude Medicine &amp; Biology"],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:p>\n                    Mittermair, Christof, Eva Foidl, Bernd Wallner, Hermann Brugger, and Peter Paal. Extreme cooling rates in avalanche victims: case report and narrative review.\n                    <jats:italic toggle=\"yes\">High Alt Med Biol<\/jats:italic>\n                    . 22: 235\u2013240, 2021.\n                  <\/jats:p>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>We report a 25-year-old female backcountry skier who was buried by an avalanche during ascent. A cooling rate of 8.5\u00b0C\/h from burial to hospital is the fastest reported in a person with persistent circulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A case report according to the CARE guidelines is presented. A literature search with the keywords \u201cavalanche\u201d AND \u201chypothermia\u201d was performed and yielded 96 results, and the last update was on October 25, 2020. A narrative review complements this work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A literature search revealed four avalanche patients with extreme cooling rates (&gt;5\u00b0\/h). References of included articles were searched for further relevant studies. Nineteen additional pertinent articles were included. Overall, 32 studies were included in this work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>An avalanche patient cools in different phases, and every phase may have different cooling rates: (1) during burial, (2) with postburial exposure on-site, and (3) during transport. It is important to measure the core temperature correctly, ideally with an esophageal probe. Contributing factors to fast cooling are sweating, impaired consciousness, no shivering, wearing thin monolayer clothing and head and hands uncovered, an air pocket, and development of hypercapnia, being slender.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Rescuers should be prepared to encounter severely hypothermic subjects (&lt;30\u00b0C) even after burials of &lt;60 minutes. Subjects rescued from an avalanche may cool extremely fast the more contributing factors for rapid cooling exist. After avalanche burial (\u226560 minutes) and unwitnessed cardiac arrest, chances of neurologically intact survival are small and depend on rapid cooling and onset of severe hypothermia (&lt;30\u00b0C) before hypoxia-induced cardiac arrest.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/ham.2020.0222","type":"journal-article","created":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T18:21:06Z","timestamp":1616610066000},"page":"235-240","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":34,"title":["Extreme Cooling Rates in Avalanche Victims: Case Report and Narrative Review"],"prefix":"10.1177","volume":"22","author":[{"given":"Christof","family":"Mittermair","sequence":"first","affiliation":[{"name":"Department of Surgery, Hospitallers Brothers Hospital, Paracelsus Medical University, Salzburg, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Foidl","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, Kufstein Hospital, Kufstein, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Wallner","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and General Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria."},{"name":"Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Brugger","sequence":"additional","affiliation":[{"name":"Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy."},{"name":"International Commission of Mountain Emergency Medicine (ICAR MEDCOM), Kloten, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Paal","sequence":"additional","affiliation":[{"name":"International Commission of Mountain Emergency Medicine (ICAR MEDCOM), Kloten, Switzerland."},{"name":"Department of Anaesthesiology and Intensive Care Medicine, Hospitallers Brothers Hospital, Paracelsus Medical University, Salzburg, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,23]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03410030093036"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2014.06.015"},{"key":"e_1_3_5_4_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.resuscitation.2015.06.020","article-title":"Cooling rate for triage decisions should exclude post-extrication cooling in avalanche victims","volume":"94","author":"Brugger H","year":"2015","unstructured":"Brugger H, , Procter E, , Rauch S, , and Strapazzon G. 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