Severe hypothermia leads to cardiac instability; however, it also has protective effects due to decreased metabolic activity. Therefore, prolonged resuscitation is advised in hypothermic cardiac arrest. We present a case of severe hypothermia without asphyxia, which is very important prognostically, leading to ventricular fibrillation. Conventional rewarming methods did not result in a higher body temperature. Extracorporeal circulation and rewarming was started after 210 minutes of conventional but adequate cardiopulmonary resuscitation. Good neurological recovery was observed after prolonged support on the intensive care unit. This case and other cases described in the literature should create awareness regarding the importance of prolonged resuscitation in hypothermic cardiac arrest. Extracorporeal rewarming and support could contribute to excellent recovery and therefore must be considered in similar cases.
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