From the Guidelines
Acute hypothermia is a medical emergency that occurs when the core body temperature drops below 35°C, resulting in a range of symptoms and potentially life-threatening complications.
Definition and Causes
- Acute hypothermia is defined as a core body temperature below 35°C, with mild hypothermia ranging from 35°C to 32°C, moderate hypothermia from 32°C to 28°C, and severe hypothermia below 28°C 1.
- It can occur due to various factors, including exposure to cold environments, wet clothing, and certain medical conditions, with risk factors including age, impaired temperature regulation, and severity of injury 1.
Symptoms and Stages
- Symptoms of acute hypothermia may include shivering, confusion, drowsiness, and loss of coordination, with more severe cases leading to cardiac arrest and death 1.
- The stages of hypothermia progress in a continuum, with mild hypothermia characterized by shivering and cold stress, moderate hypothermia by confusion and disorientation, and severe hypothermia by loss of consciousness and cardiac arrest 1.
Treatment and Management
- Treatment of acute hypothermia involves rewarming the patient using passive or active measures, such as removing wet clothing, using warming blankets, and administering warm intravenous fluids 1.
- Early goal-directed management is crucial in preventing hypothermia-related morbidity and mortality, particularly in severely injured trauma patients, with a focus on damage control resuscitation and aggressive rewarming 1.
From the Research
Definition of Acute Hypothermia
- Acute hypothermia is defined as a core body temperature below 35°C 2, 3, 4
- It occurs when the body's ability to maintain thermal homeostasis is impaired, leading to a drop in core temperature 2
- Hypothermia can be classified as accidental or intentional, with accidental hypothermia occurring when endogenous temperature control mechanisms are incapable of maintaining core body temperature within physiologic limits 3
Causes and Classification of Hypothermia
- Accidental hypothermia can be caused by exposure to a cold environment, drugs, or illness 2
- Intentional hypothermia, also known as therapeutic hypothermia, is induced for medical purposes, such as to reduce the risk of cerebral or cardiac ischemic damage 2, 5, 6
- Hypothermia can be classified as mild, moderate, or severe, depending on the degree of temperature drop 2
Physiological Effects of Hypothermia
- Hypothermia disrupts physiological processes at the molecular, cellular, and system level 2
- Therapeutic hypothermia can reduce the risk of cerebral or cardiac ischemic damage by decreasing tissue oxygen demand 2, 5
- However, hypothermia can also have detrimental effects, such as cardiac arrhythmias, uncontrolled bleeding, and "rewarming shock" 3