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Accidental hypothermia: rewarming treatments, complications and outcomes from one university medical centre

Authors
van der Ploeg, Gert-Jan
Goslings, J Carel
Bierens, Joost J L. M.
Published in Resuscitation. 2010, vol. 81, no. 11, p. 1550-1555
Abstract AIM OF THE STUDY: Accidental hypothermia (AH) is a complex and life threatening condition. Knowledge about epidemiology, rewarming treatments, complications and outcome is limited. This study was initiated to obtain data on causes, rewarming treatments and complications. METHODS: A retrospective cohort study of all patients with a body temperature </= 35 degrees C admitted to the Emergency Department (ED) of the VU university medical centre, Amsterdam, The Netherlands, between January 1, 2000 and August 31, 2008. A predefined set of epidemiological and clinical data was retrieved. RESULTS: Eighty-four patients were included (median age: 47 years). Categories of hypothermia included immersion (18), submersion (29) and exposure to cold (37); concomitant factors were intoxication (26), trauma (40) and homelessness (7). Temperature at admission in the ED was 31.6 +/- 2.6 degrees C (mean +/- SD), lowest temperature 24.2 degrees C. Fourteen different rewarming treatments were used resulting in a wide range of rewarming speeds. Seventy-nine complications occurred: pulmonary, renal and neurological complications in 20, 17 and 10 patients respectively. Seventeen patients had 2 or more late complications. Twenty-four patients (28.6%) died: 10 during rewarming and 14 after rewarming was completed. Prognosis was poor in older and colder patients and after indoor exposure and submersion. CONCLUSION: AH is a rare diagnosis in an inhomogeneous population, treated with a large variety of rewarming techniques. Most complications and death occurred late, after rewarming was completed. Because individual teams gain little clinical experiences, we suggest multiple centre data collection as a first step towards an evidence-based standard of care.
Keywords AdultAnalysis of VarianceBody TemperatureChi-Square DistributionFemaleHumansHypothermia/*complications/epidemiology/*therapyMaleMiddle AgedNetherlands/epidemiologyPrognosisRetrospective StudiesRewarming/*methodsRisk FactorsStatistics, NonparametricTreatment Outcome
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PMID: 20702016
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Other version: http://www.sciencedirect.com/science/journal/03009572
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VAN DER PLOEG, Gert-Jan et al. Accidental hypothermia: rewarming treatments, complications and outcomes from one university medical centre. In: Resuscitation, 2010, vol. 81, n° 11, p. 1550-1555. https://archive-ouverte.unige.ch/unige:21361

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Deposited on : 2012-05-23

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