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Published on: November 20, 2015
Profound Hypothermia Concomitant With Severe Coagulation Dysfunction and Leukopenia in a Preterm Infant: A Case
Enfu Tao1, Caie Chen, Yunqin Chen
1Gastrointestinal Laboratory (Dr Tao), Department of Neonatology (Dr Yuan), Office of National Clinical Research Center for Child Health (Dr Fu), and Department of Gastroenterology (Dr Jiang), Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China; and Department of Pediatrics, Wenling Maternal and Child Health Care Hospital, Wenling, Zhejiang, China (Drs Tao, C. Chen, and Xie and Y. Chen).
Background:
Neonatal hypothermia is common around the world; however, profound hypothermia is a very rare-but life-threatening-event.
Clinical Findings:
This was a very rare case involving a 15-day old preterm infant diagnosed with profound hypothermia (rectal temperature, 27°C) concomitant with severe coagulation dysfunction and leukopenia on admission.
Primary Diagnosis:
Profound hypothermia together with severe coagulopathy, leukopenia, late-onset sepsis, and pneumonia.
Interventions:
The patient was rewarmed slowly, with a rectal temperature rising at a rate of 0.5°C/h < R < 1°C/h. Vital signs were closely monitored. Coagulation factors were supplemented by intravenous infusion of fresh frozen plasma. Supportive treatment with intravenous infusion of immunoglobulin was provided, and antibiotics were used empirically. Nil per os and intravenous rehydration were also implemented.
Outcomes:
The condition of the preterm infant gradually improved and was successfully discharged.
Practice Recommendations:
Profound hypothermia is very rare in preterm infants. However, once it occurs, it may be concomitant with severe coagulopathy and leukopenia. Successful management involves slow rewarming, prompt supplementation of coagulation factors, empirical antibiotics, and supportive treatment.
