[Deep subacute accidental hypothermia. A case with an unusual clinical picture and course]

A case of a patient with core temperature of 24.4 degrees C, presenting an unusual clinical picture, is described. A 68 year-old man was found outdoors after being exposed to five to eight hours of coldness. He was found awake, with dry clothes and an alcohol foetor. After eight hours the serum ethanol was measured as 6 mmol/l. He could not speak but was able to move all four extremities. A sinus bradycardia of 23 beats per minute was present but no other arrhythmia was seen. The temperature rose to 31.2 degrees C within four hours and body temperature was normal after 10 hours. The only treatment given was passive rewarming with blankets and 2.5 l isotonic NaCl warmed to 40 degrees C given intravenously. This clinical picture supports the assumption that ethanol protects the myocardium against arrhythmias in deep hypothermia.