scholarly journals Severe Hypothermia: Challenging Normal Physiology

2005 ◽  
Vol 33 (5) ◽  
pp. 662-664 ◽  
Author(s):  
J. Brieva ◽  
B. Mcfadyen ◽  
M. Rowley
Keyword(s):  
Cause Of Death ◽  
Core Temperature ◽  
Accidental Hypothermia ◽  
Severe Hypothermia

Accidental hypothermia is not a frequent cause of death in Australia. Moreover it is rare to have an admission to hospital with a core temperature below 32°C. Among the cases described in the literature, it is clear that temperature and prognosis are related. Our patient presented with severe accidental hypothermia and even though the admission core temperature was below 26 degrees she was successfully discharged from hospital after active re-warming with three different devices. She had laboratory and ECG findings associated with severe hypothermia.

The International Hypothermia Registry (IHR): Dieter's ESAO Winter Schools and Beat's International Hypothermia Registry

2017 ◽  
Vol 40 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Beat H. Walpoth ◽  
Marie Meyer ◽  
Christophe Gaudet-Blavignac ◽  
Philippe Baumann ◽  
Pierre Gilquin ◽  
...  
Keyword(s):  
Mild Hypothermia ◽  
Statistical Significance ◽  
Orphan Disease ◽  
Accidental Hypothermia ◽  
Evidence Based ◽  
Outcome Predictors ◽  
Severe Hypothermia ◽  
Life Threatening

Accidental hypothermia could be listed as an ‘orphan disease,’ since mild hypothermia is common but has no severe medical consequences, whereas severe hypothermia is rare and life-threatening. In order to increase our knowledge, find new outcome predictors, and propose better guidelines for the treatment of deep accidental hypothermia victims, we created the International Hypothermia Registry (IHR: https://www.hypothermia-registry.org ), which will allow us to gather a large number of cases in order to achieve statistical significance and issue evidence-based recommendations.

scholarly journals Can body temperature be maintained during aeromedical transport?

CJEM ◽  
2002 ◽  
Vol 4 (03) ◽  
pp. 172-177 ◽  
Author(s):  
Sunil M. Sookram ◽  
Samantha Barker ◽  
Karen D. Kelly ◽  
William Patton ◽  
Terry Sosnowski ◽  
...  
Keyword(s):  
Body Temperature ◽  
Core Temperature ◽  
Mild Hypothermia ◽  
Severely Injured ◽  
Severe Hypothermia ◽  
Northern Areas ◽  
Aeromedical Transport ◽  
Regional Hospitals ◽  
Rotary Wing ◽  
Northern Alberta

ABSTRACTBackground:Aeromedical transport in northern areas may be associated with hypothermia. The objective of this study was to determine whether significant hypothermia (core temperature <35ºC) occurs in severely injured or ill intubated patients during transport by rotary wing aircraft.Methods:In this prospective cohort study, all intubated patients over 16 years of age who were transported by rotary wing aircraft from rural hospitals or trauma scenes in northern Alberta to regional hospitals in Edmonton were eligible for study. Esophageal thermometers were used to measure core temperature at 10-minute intervals during transport.Results:Of 133 potentially eligible patients, 116 were enrolled; 69 (59%) had esophageal thermometers inserted, and 47 (41%) had other temperature measurements. Severe hypothermia occurred in only 1% to 2% of cases, but 28% to 39% of patients met criteria for mild hypothermia prior to transport. Core temperatures did not fall during transport, despite the fact that warming techniques were documented in only 38% of cases.Conclusions:During brief (<225 km) rotary wing aeromedical transport of severely injured or ill patients, significant hypothermia is uncommon and body temperature is generally well maintained with the use of simple passive measures. These findings do not justify recommendations for more aggressive core temperature monitoring during this type of aeromedical transport.

scholarly journals Efficacy of forced-air and inhalation rewarming by using a human model for severe hypothermia

1997 ◽  
Vol 83 (5) ◽  
pp. 1635-1640 ◽  
Author(s):  
M. S. L. Goheen ◽  
M. B. Ducharme ◽  
G. P. Kenny ◽  
C. E. Johnston ◽  
John Frim ◽  
...  
Keyword(s):  
Ambient Temperature ◽  
Core Temperature ◽  
Cumulative Dose ◽  
Thermal Model ◽  
Human Model ◽  
The Core ◽  
Severe Hypothermia ◽  
Forced Air Warming ◽  
Forced Air

Goheen, M. S. L., M. B. Ducharme, G. P. Kenny, C. E. Johnston, John Frim, Gerald K. Bristow, and Gordon G. Giesbrecht.Efficacy of forced-air and inhalation rewarming by using a human model for severe hypothermia. J. Appl. Physiol. 83(5): 1635–1640, 1997.—We recently developed a nonshivering human model for severe hypothermia by using meperidine to inhibit shivering in mildly hypothermic subjects. This thermal model was used to evaluate warming techniques. On three occasions, eight subjects were immersed for ∼25 min in 9°C water. Meperidine (1.5 mg/kg) was injected before the subjects exited the water. Subjects were then removed, insulated, and rewarmed in an ambient temperature of −20°C with either 1) spontaneous rewarming (control), 2) inhalation rewarming with saturated air at ∼43°C, or 3) forced-air warming. Additional meperidine (to a maximum cumulative dose of 2.5 mg/kg) was given to maintain shivering inhibition. The core temperature afterdrop was 30–40% less during forced-air warming (0.9°C) than during control (1.4°C) and inhalation rewarming (1.2°C) ( P< 0.05). Rewarming rate was 6- to 10-fold greater during forced-air warming (2.40°C/h) than during control (0.41°C/h) and inhalation rewarming (0.23°C/h) ( P< 0.05). In nonshivering hypothermic subjects, forced-air warming provided a rewarming advantage, but inhalation rewarming did not.

scholarly journals Accidental Hypothermia: 2021 Update

2022 ◽  
Vol 19 (1) ◽  
pp. 501
Author(s):  
Peter Paal ◽  
Mathieu Pasquier ◽  
Tomasz Darocha ◽  
Raimund Lechner ◽  
Sylweriusz Kosinski ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Core Temperature ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Clinical Signs ◽  
Accidental Hypothermia ◽  
Care Bundle ◽  
Elderly Persons ◽  
Ventricular Dysrhythmias ◽  
Mechanical Cpr

Accidental hypothermia is an unintentional drop of core temperature below 35 °C. Annually, thousands die of primary hypothermia and an unknown number die of secondary hypothermia worldwide. Hypothermia can be expected in emergency patients in the prehospital phase. Injured and intoxicated patients cool quickly even in subtropical regions. Preventive measures are important to avoid hypothermia or cooling in ill or injured patients. Diagnosis and assessment of the risk of cardiac arrest are based on clinical signs and core temperature measurement when available. Hypothermic patients with risk factors for imminent cardiac arrest (temperature < 30 °C in young and healthy patients and <32 °C in elderly persons, or patients with multiple comorbidities), ventricular dysrhythmias, or systolic blood pressure < 90 mmHg) and hypothermic patients who are already in cardiac arrest, should be transferred directly to an extracorporeal life support (ECLS) centre. If a hypothermic patient arrests, continuous cardiopulmonary resuscitation (CPR) should be performed. In hypothermic patients, the chances of survival and good neurological outcome are higher than for normothermic patients for witnessed, unwitnessed and asystolic cardiac arrest. Mechanical CPR devices should be used for prolonged rescue, if available. In severely hypothermic patients in cardiac arrest, if continuous or mechanical CPR is not possible, intermittent CPR should be used. Rewarming can be accomplished by passive and active techniques. Most often, passive and active external techniques are used. Only in patients with refractory hypothermia or cardiac arrest are internal rewarming techniques required. ECLS rewarming should be performed with extracorporeal membrane oxygenation (ECMO). A post-resuscitation care bundle should complement treatment.

scholarly journals Clinical Relevance of Impaired Consciousness in Accidental Hypothermia: A Japanese Multicenter Retrospective Study

2020 ◽  
Author(s):  
Masahiro Fukuda ◽  
Masahiro NOZAWA ◽  
Yohei OKADA ◽  
Sachiko MORITA ◽  
Naoki EHARA ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Likelihood Ratio ◽  
Clinical Relevance ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Accidental Hypothermia ◽  
Impaired Consciousness ◽  
Severe Hypothermia ◽  
Level Of Consciousness ◽  
The Relationship

Abstract Background: Severe accidental hypothermia (AH) is a life-threatening condition, and early identification can enable transport to an appropriate medical facility. The Swiss staging model has been used to classify patients with AH, but little is known regarding the relationship between the degree of impaired consciousness and core body temperature (BT) in AH. This study aimed to clarify the relationship between the level of consciousness and core BT and determine whether the level of consciousness could be used to predict severe hypothermia and in-hospital mortality among patients with AH.Methods: We retrospectively investigated the clinical relevance of impaired consciousness in AH. We included adult patients with AH and excluded patients with out-of-hospital cardiac arrest. The patients were identified from the J-point registry, which contains information regarding patients treated for AH between April 1, 2011 and March 31, 2016 in any of the 12 participating institutions in Japan. The primary exposure of interest was the level of consciousness at hospital arrival. Odds ratios were calculated for severe hypothermia and in-hospital mortality.Results: Overall, 505 of the 572 patients in the registry were included. Compared to mildly impaired consciousness, the adjusted odds ratio for severe hypothermia was 3.3 (95% confidence interval [CI]: 1.7–6.3) for moderately impaired consciousness and 4.7 (95% CI: 2.4–9.1) for severely impaired consciousness. Severely impaired consciousness as a predictor severe hypothermia had a sensitivity of 0.44 (95% CI: 0.34–0.54), specificity of 0.78 (95% CI: 0.74–0.82), positive likelihood ratio of 2.04, and negative likelihood ratio of 0.71. Compared to mildly impaired consciousness, the adjusted odds ratio for in-hospital mortality was 1.7 (95% CI: 0.95–2.9) for moderately impaired consciousness and 2.1 (95% CI: 1.2–3.8) for severely impaired consciousness.Conclusions: Severely impaired consciousness was a reliable predictor of severe hypothermia and in-hospital mortality in patients with AH. Thus, in an urban out-of-hospital emergency setting, the level of impaired consciousness may be helpful for triaging patients to the appropriate hospital.

scholarly journals Clinical relevance of impaired consciousness in accidental hypothermia: A Japanese multicenter retrospective study

2021 ◽  
Author(s):  
Masahiro Fukuda ◽  
Masahiro Nozawa ◽  
Yohei Okada ◽  
Sachiko Morita ◽  
Naoki Ehara ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Core Body Temperature ◽  
Staging System ◽  
Accidental Hypothermia ◽  
Impaired Consciousness ◽  
Odds Ratios ◽  
Severe Hypothermia ◽  
Threatening Condition ◽  
Life Threatening ◽  
Core Body

Abstract Background This study aimed to investigate the association between level of impaired consciousness and severe hypothermia less than 28°C among accidental hypothermia. Severe accidental hypothermia (AH) is a life-threatening condition, and early identification can enable transport to an appropriate medical facility. The Swiss staging system has been used to classify patients with AH, but little is known regarding the association between the level of impaired consciousness and core body temperature (BT) in AH. This study aimed to clarify the association between level of impaired consciousness and core BT and determine whether the level of impaired consciousness could be used to predict severe hypothermia and in-hospital mortality among patients with AH. Results The study included 505 of 572 patients in the J-point registry. Relative to mildly impaired consciousness (Glasgow coma scale (GCS) 13–15), the adjusted odds ratios for severe hypothermia were moderate (GCS9-12) 3.26 (95% CI: 1.69–6.25) and severe (GCS < 9) 4.68 (95% CI: 2.40–9.14) for severely impaired consciousness. Relative to mildly impaired consciousness (GCS 13–15), the adjusted odds ratios for in-hospital mortality were moderate (GCS9-12) 1.65 (95% CI: 0.95–2.88) and severe (GCS < 9) 2.10 (95% CI: 1.17–3.78). Conclusions The level of impaired consciousness in patients with accidental hypothermia may predict severe hypothermia and in-hospital mortality.

scholarly journals The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia—Systematic Review of the Literature

2021 ◽  
Vol 18 (18) ◽  
pp. 9638
Author(s):  
Konrad Mendrala ◽  
Sylweriusz Kosiński ◽  
Paweł Podsiadło ◽  
Mathieu Pasquier ◽  
Peter Paal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Data Extraction ◽  
Deep Hypothermia ◽  
Accidental Hypothermia ◽  
Review Of The Literature ◽  
Severe Hypothermia ◽  
Resuscitation Guidelines ◽  
The Mean

Background: Renal replacement therapy (RRT) can be used to rewarm patients in deep hypothermia. However, there is still no clear evidence for the effectiveness of RRT in this group of patients. This systematic review aims to summarize the rewarming rates during RRT in patients in severe hypothermia, below or equal to 32 °C. Methods: This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (identifier CRD42021232821). We searched Embase, Medline, and Cochrane databases using the keywords hypothermia, renal replacement therapy, hemodialysis, hemofiltration, hemodiafiltration, and their abbreviations. The search included only articles in English with no time limit, up until 30 June 2021. Results: From the 795 revised articles, 18 studies including 21 patients, were selected for the final assessment and data extraction. The mean rate of rewarming calculated for all studies combined was 1.9 °C/h (95% CI 1.5–2.3) and did not differ between continuous (2.0 °C/h; 95% CI 0.9–3.0) and intermittent (1.9 °C/h; 95% CI 1.5–2.3) methods (p > 0.9). Conclusions: Based on the reviewed literature, it is currently not possible to provide high-quality recommendations for RRT use in specific groups of patients in accidental hypothermia. While RRT appears to be a viable rewarming strategy, the choice of rewarming method should always be determined by the specific clinical circumstances, the available resources, and the current resuscitation guidelines.

Deep Accidental Hypothermia with Core Temperature Below 24°C Presenting with Vital Signs

2014 ◽  
Vol 15 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Mathieu Pasquier ◽  
Noemi Zurron ◽  
Barbara Weith ◽  
Pierre Turini ◽  
Fabrice Dami ◽  
...  
Keyword(s):  
Core Temperature ◽  
Vital Signs ◽  
Accidental Hypothermia

scholarly journals Bradycardia in a newborn with accidental severe hypothermia: treat or don’t touch? A case report

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Astrid Kuonen ◽  
Thomas Riva ◽  
Gabor Erdoes
Keyword(s):  
Body Temperature ◽  
Clinical Presentation ◽  
Prolonged Exposure ◽  
Accidental Hypothermia ◽  
Effective Measure ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
Severe Hypothermia ◽  
Passive Rewarming ◽  
Accidental Severe Hypothermia

Abstract Background Hypothermia significantly affects mortality and morbidity of newborns. Literature about severe accidental hypothermia in neonates is limited. We report a case of a neonate suffering from severe accidental hypothermia. An understanding of the physiology of neonatal thermoregulation and hypothermia is important to decide on treatment. Case presentation A low-birth-weight newborn was found with severe accidental hypothermia (rectal temperature 25.7 °C) due to prolonged exposure to low ambient temperature. The newborn presented bradycardic, bradypnoeic, lethargic, pale and cold. Bradycardia, bradypnea and impaired consciousness were interpreted in the context of the measured body temperature. Therefore, no reanimation or intubation was initiated. The newborn was closely monitored and successfully treated only with active and passive rewarming. Conclusion Clinical parameters such as heart frequency, blood pressure, respiration and consciousness must be interpreted in light of the measured body temperature. Medical treatment should be adapted to the clinical presentation. External rewarming can be a safe and effective measure in neonatal patients.

Emergency treatment of accidental hypothermia

1971 ◽  
Vol 9 (2) ◽  
pp. 5-7
Keyword(s):  
Body Temperature ◽  
Cause Of Death ◽  
Emergency Treatment ◽  
Accidental Hypothermia ◽  
British Isles ◽  
Healthy Individuals ◽  
Old People ◽  
Exposure To Cold ◽  
Body Cooling

Accidental hypothermia is defined as a body temperature lower than 35° C (95° F) in otherwise healthy individuals, resulting from excessive exposure to cold. Any thin person immersed in water around the British Isles for several hours, even in summer, is liable to suffer a dangerous degree of body cooling, and accidental hypothermia is the commonest cause of death after shipwreck.1 2 Hill walkers who lose their way or collapse from exhaustion may die of cold.3 Infants4 and some old people5 are particularly liable to hypothermia as they are less well able to conserve heat.

Sign in / Sign up

Export Citation Format

Share Document