Hypothermia

From WikiLectures

Hypothermia occurs when the body temperature drops below 35°C due to excessive heat loss.

Causes of hypothermia[edit | edit source]

  • Environmental influence - 'hypothermia (+ high humidity, wind, physical exhaustion, drunkenness, injuries, ...)
  • Reduced metabolism - severe hypothyroidism, hypoglycemia, hypopituitarism, ketoacidosis, malnutrition
  • Intoxication (alcohol, barbiturates, sedatives)
  • Brain damage, trauma, sepsis
  • Increased heat loss through the skin - burns

Consequences of hypothermia[edit | edit source]

  • The first signs arise from the effect of abnormal temperature on the CNS - ataxia, amnesia, speech disorders, behavior (paradoxical undressing), hallucinations, ...
  • Below 33 °C, muscle tremors stop, metabolism decreases (at 28°C by 50%)
  • Hematocrit and viscosity of the blood increase
  • Impaired renal function - cold diuresis followed by oliguria
  • Rise in pH (spontaneous return when the temperature rises)
  • Impaired detoxification and conjugation function of the liver, hyperglycemia
  • Often pancreatitis and gastric bleeding
An example of an Osborn J wave in a hypothermic person.

Effect on the heart

  • Progressive decline of heart rate and MSV!
  • Blood pressure first rises, then falls - poorly palpable pulse
  • Despite hyperkalemia, myocardial excitability increases - frequent atrial fibrillation
  • When the temperature drops below 28 - 30 °C risk of ventricular fibrillation! (terminal stage!)
  • Changes on ECG (Osborn wave)

The body can cope with hypothermia (up to 20 °C) surprisingly well. This is because there is a reduction in metabolism and requirements for O2. Therefore, prolonged resuscitation is recommended and justified in critical hypothermic states. In case of death due to hypothermia, the postmortem signs are - purple skin, swelling in the face, gastric erosion, multi-organ infarctions as a result of hypothermic shock.

Use of hypothermia in medicine[edit | edit source]

Links[edit | edit source]

Related Articles[edit | edit source]

External links[edit | edit source]

References[edit | edit source]

BLATTEIS, Clark. Physiology and Pathophysiology of Temperature Regulation. - edition. World Scientific, 1998. 294 pp. ISBN 9789810231729.