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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">First of all&#44; we thank Dr&#46; Ferrer Marrero for his interest in our article&#44; which demonstrates the concern and growing interest of professionals involved in the management of accidental hypothermic victims&#44; including cold water immersion and drowning&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We agree with the author the requirement of a good coordination between the rescue teams&#44; pre-hospital emergency systems&#44; and useful hospitals&#46; In fact&#44; in 1991&#44; we already expressed this desire&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> Since then&#44; the criteria have changed a lot and&#44; in the recent years&#44; survival has been revolutionized with excellent neurological results&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Further progress must be made in the development of structured protocols that plan rescue coordination&#44; problem prediction&#44; triage optimization&#44; pre-hospital management including immediate and high quality CPR&#44; transportation and treatment&#46; These protocols should include&#59; hospital choice&#44; hospital management&#44; detailed criteria for the use of ECMO and cardiorespiratory support and subsequent resuscitation care&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> An example of this coordination has recently been published in non-scientific press&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> A severe hypothermic victim in cardiac arrest in the Gerona&#39;s Pyrenees was resuscitated after 6<span class="elsevierStyleHsp" style=""></span>h without neurological sequela&#46; The victim was transported to The Vall d&#8217;Hebron Hospital in Barcelona for extracorporeal life support rewarming&#46; This achievement originated a press release from the Spanish Society of Intensive and Critical Care Medicine and Coronary Units &#40;SEMICYUC&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Furthermore&#44; we believe that&#44; due to the low frequency of this pathology and the difficulty to make the good decision at the accident site&#44; the advice of an expert in hypothermia &#40;called coordinator in other countries&#41; could be useful&#46; Its effectiveness improving survival and final neurological prognosis has been reported&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding source</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that the article has not received any funding&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that none of the signatories has a conflict of interest&#46;</p></span></span>"
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Letter to the Editor
In reply to “Management of accidental hypothermia: Narrative review”
En respuesta a “Gestión de la hipotermia accidental: revisión narrativa”
M.L. Avellanas Chavalaa,b,c,
Corresponding author
mlavellanas@gmail.com

Corresponding author.
, M. Ayala Gallardod, I. Soteras Martíneze,f,g, E. Subirats Bayegof,g
a Unidad de Medicina Intensiva, Hospital General San Jorge, Huesca, Spain
b Unidad Funcional de Congelaciones y Patologías de Montaña, Hospital General San Jorge, Huesca, Spain
c Profesor del Master en Medicina de Urgencia y Rescate en Montaña, Universidad de Zaragoza, Spain
d Servicio 061 – Montaña Aragón, Spain
e Servicio de Urgencias, Spain
f Hospital de Cerdanya, Puigcerdá (Girona), Spain
g Facultad de Medicina, Universidad de Girona, Spain
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