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Pathophysiology of accidental hypothermia
1Medical Assessment Unit, Royal United Hospital, Bath, UK. mark.mallet@ruh-bath.swest.nhs.uk
QJM : Monthly Journal of the Association of Physicians
|November 28, 2002
Summary
Accidental hypothermia, especially in the elderly, involves various risk factors like sepsis. Rewarming reverses most physiological changes, but some damage may occur during the rewarming process itself.
Area of Science:
- Physiology
- Pathophysiology
- Internal Medicine
Background:
- Accidental hypothermia is an uncommon condition affecting all ages, with a higher prevalence in the elderly.
- Predisposing factors include sepsis, though cold-water immersion is not covered.
Purpose of the Study:
- To review etiological factors of hypothermia.
- To analyze the pathophysiology across multiple organ systems.
- To highlight clinically relevant findings and management considerations.
Main Methods:
- Literature review focusing on hypothermia's effects.
- Analysis of physiological changes in cardiovascular, haematological, neurological, respiratory, renal, metabolic, and gastrointestinal systems.
Main Results:
- Hypothermia affects multiple organ systems, causing significant physiological changes.
- Most changes are reversible upon rewarming.
- Rewarming itself can cause pathological effects distinct from hypothermia.
Conclusions:
- Understanding hypothermia's pathophysiology is crucial for management.
- Pharmacological interventions are largely ineffective.
- The rewarming process requires careful consideration to minimize iatrogenic harm.