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Rationale:
- Hypothermia initially stimulates stress-related homeostatic mechanisms that are gradually suppressed as hypothermia progresses.
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Evidence:
- In hypothyroid states, low free T3, but not low free T4, appears to regulate the basal metabolic rate and hence thermogenesis (126). At least in rats, a hypothyroid state appears to lower the set-point for core temperature (127).
- In severe caloric restriction, carbohydrate deprivation may contribute to hypothermia by inhibiting sympathetic activity and
thus thermogenesis (128).
- Reversible hypothermia has been linked to thiamine deficiency in anorexia nervosa (129) and Wernicke-Korsakoff syndrome (130).
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Comments:
- Although seen in sporadic cases of hypothermia (131), there is dispute whether pancreatitis is a direct complication of hypothermia or the result of other coincidental processes
(132).
- Wischnewsky spots are blackish-brown lesions found in the gastric mucosa thought to be suggestive, if not pathognomonic, of
hypothermia and are thus helpful in the postmortem establishment of hypothermia as a contributor to death. They represent
hemorrhage within the gastric glands (133).
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Albert Cheung, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Dmitri Guvakov, MD, PhD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Stuart Weiss, MD, PhD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Wenjun Zhou Martini, PhD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for
continuing medical education grand rounds and lectures given.
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PIER is copyrighted (c) 2010 by the American College of Physicians,
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Hypothermia
> Diagnosis
