[Cold-induced pathology at high altitude]

Cold injury is an objective danger in mountain climbing as well as in many outdoor and recreational sports such as skiing, fishing, etc. Symptoms are easily recognizable by the experienced, and prevention is mostly possible. Cold injury should be divided by pathological means in general hypothermia and local frostbite injuries. Life-threatening deep hypothermia with coma and insufficient circulation or cardiac arrest is reversible under the condition of sufficient core rewarming, for instance by CEC. Because of the big tolerance of hypothermic patients to hypoxia, clinical death is not like biological death and therefore reversible. Local frostbite is not life-threatening, but has often deleterious effects. Rapid rewarming in warm water of 37 to 42 degrees C is mandatory. After rewarming, the difference between superficial and deep frostbite can be established. Scintigraphy seems to be of great help in setting early prognosis. Daily sterile treatment of the injury, whirlpool bath and prevention of infections belong to standard treatment. There are little objective informations about the role of vasodilators, anticoagulants, antibiotics, sympathectomy and others. Early experience with Prostavasine seems to bee encouraging.