[Accidental hypothermia. Physiopathology, clinical manifestations and treatment]

The article reviews pathophysiology and clinical problems. During deep hypothermia, criteria for death are obscured. Prehospital treatment should be vigorous resuscitation on broad indications. Asystole or ventricular fibrillation is common. Drugs are contraindicated, with the possible exception of bretyllium. Electro-conversion of the heart is usually impossible below 28-30 degrees Centigrade. Hypothermic victims must be handled with the utmost care. Rewarming may cause life-threatening arrythmias, afterdrop and "rewarming collapse". Rewarming should take place in hospital only. Different methods of rewarming are discussed. Probably the best way to treat deeply hypothermic victims is by cardiopulmonary bypass.