[The significance of hypothermia in polytrauma patients]

Hypothermia is a frequent event in trauma patients and appears to be related to posttraumatic organ dysfunction, although in elective surgery hypothermia is known to prevent ischemia reperfusion injury. Retrospectively, we analyzed data of 641 trauma patients treated in our institution between 1988 and 1993. At hospital admission the core temperature (cT) was > 34 degrees C in the majority (64%) of all patients, < 34 degrees C in 23.6% and < 32 degrees C in 12.4%. At 24 99% had cT of > 34 degrees C. Lethality was twice as high (53%) in patients with cT < 32 degrees C as in patients with cT > 34 degrees C (28%). Analysis of correlation revealed that hypothermia was paralleled by a longer rescue time, greater severity of limb injury, and hypoxia. It also appeared that hypothermia is not an independent prognostic factor for posttraumatic lethality. The different effects of hypothermia in trauma and elective surgery may be due to a lack of energy-storing phosphates such as adenosine triphosphate (ATP). Ongoing investigations will identify the role of ATP in trauma-related hypothermia.