At what core temperature should resuscitative efforts continue in hypothermic drowning victims?

In cases of hypothermic drowning victims, resuscitative efforts should continue until the core temperature reaches at least 30 degrees Celsius. This threshold is established based on the understanding that hypothermia can lead to a decreased metabolic rate, resulting in potential cardiac arrest. Resuscitation may still be effective even at this lower temperature, as individuals who are profoundly hypothermic can sometimes demonstrate a form of "cold survival," meaning they may still be salvaged with appropriate medical intervention even when significantly cooled.

Continuing resuscitation efforts at this temperature acknowledges that certain physiological mechanisms remain intact, allowing for the possibility of return of spontaneous circulation (ROSC) despite severe hypothermia. The rationale is that the cold can provide a protective effect on the brain and other vital organs, reducing the demand for oxygen during resuscitation. Therefore, efforts should persist until the victim reaches at least 30 degrees Celsius to maximize the chances of successful resuscitation and recovery.