Management of accidental hypothermia: A narrative review
Med Intensiva (Engl Ed). 2019 Dec;43(9):556-568.
doi: 10.1016/j.medin.2018.11.008.
Epub 2019 Jan 22.
[Article in
English,
Spanish]
Affiliations
- 1 Unidad de Medicina Intensiva, Hospital General San Jorge, Huesca, España; Unidad Funcional de Congelaciones y Patologías de Montaña, Hospital General San Jorge, Huesca, España; Máster en Medicina de Urgencia y Rescate en Montaña, Universidad de Zaragoza, Zaragoza, España. Electronic address: mlavellanas@ono.com.
- 2 Servicio 061, Montaña Aragón.
- 3 Servicio de Urgencias; Hospital de Cerdanya, Puigcerdà, Gerona, España; Facultad de Medicina, Universidad de Girona, Gerona, España.
- 4 Hospital de Cerdanya, Puigcerdà, Gerona, España; Facultad de Medicina, Universidad de Girona, Gerona, España.
Abstract
A narrative review is presented on the diagnosis, treatment and management of accidental hypothermia. Although all these processes form a continuum, for descriptive purposes in this manuscript the recommendations are organized into the prehospital and in-hospital settings. At prehospital level, it is advised to: a) perform high-quality cardiopulmonary resuscitation for cardiac arrest patients, regardless of body temperature; b) establish measures to minimize further cooling; c) initiate rewarming; d) prevent rescue collapse and continued cooling (afterdrop); and (e) select the appropriate hospital based on the clinical and hemodynamic situation of the patient. Extracorporeal life support has revolutionized rewarming of the hemodynamically unstable victim or patients suffering cardiac arrest, with survival rates of up to 100%. The new evidences indicate that the management of accidental hypothermia has evolved favorably, with substantial improvement of the final outcomes.
Keywords:
Accidental hypothermia; Avalancha; Avalanche; Cardiopulmonary resuscitation; ECMO; Hipotermia accidental; Reanimación cardiopulmonar; Recalentamiento; Rescate; Rescue; Rewarming.
Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.
MeSH terms
-
Avalanches
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Biomarkers / blood
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Body Temperature
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Cardiopulmonary Resuscitation / methods*
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Cardiopulmonary Resuscitation / standards
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Cold Temperature / adverse effects
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Electric Countershock
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Emergency Medical Services*
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Extracorporeal Membrane Oxygenation / methods
-
Fluid Therapy / methods
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Hospitalization
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Humans
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Hypothermia / complications
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Hypothermia / diagnosis
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Hypothermia / therapy*
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Immersion / adverse effects
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Out-of-Hospital Cardiac Arrest / therapy*
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Oxygen Consumption
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Potassium / blood
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Rewarming / methods*