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- Recognize that moderate or severe hypothermia requires aggressive, appropriate management.
- Consider hospitalization to manage complications of hypothermia.
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Recognize that moderate or severe hypothermia requires aggressive, appropriate management.  |
- Hospitalize patients who require:
- Continual monitoring of hemodynamic and respiratory function
- Endotracheal intubation for airway stabilization
- Urgent evaluation of abnormal physiologic or neurologic findings
- Treatment of confounding or concomitant findings, such as trauma or hypoglycemia
- Active rewarming
- Bypass or lavage
- Be aware that the “afterdrop” (a paradoxical drop in core temperature during rewarming that occurs as cold blood from the cooler periphery returns to cool the core compartment) can lead to cardiovascular collapse.
- Be aware that rewarming can lead to cardiovascular collapse, known as “rewarming shock,” which is characterized by a decrease in cardiac output and peripheral arterial resistance, resulting in hypotension.
- See initiation of active rewarming.
| Background | Back to top
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Consider hospitalization to manage complications of hypothermia. |
- Hospitalize patients who may have complications of hypothermia, such as:
- Rewarming shock or hemodynamic instability
- Significant temperature gradient between the core and peripheral temperatures that would predispose to the phenomenon of “afterdrop.”
- Compartment syndrome
- Pulmonary complications of aspiration, pneumonia, or acute respiratory distress syndrome
- Acute renal dysfunction (i.e., acute tubular necrosis)
- Disseminated intravascular coagulation
- Significant neurologic dysfunction
- Significant peripheral extremity ischemia or frostbite/trench foot
| Background | Back to top
| | | FAQs |
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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.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott. |
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
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PIER is copyrighted (c) 2009 by the American College of Physicians,
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Hypothermia
