Accidental hypothermia: peritoneal dialysis

Accidental hypothermia may develop within a few minutes by immersion in cold water, in a matter of hours by exposure to cold weather, and in a matter of days in debilitatted victims by continuous exposure to milder cold stress. The prognosis in accidental hypothermia depends on the patient's premorbid condition, the depth and duration of the hypothermia and the degree of exhaustion and metabolic acidosis that result from physiologic attempts to compensate for the heat loss. For deep hypothermia (deep body temperature below 20 C [82.4F]), internal rewarming is strongly recommended as a means of supporting function in body core organs and minimizing the risk of "rewarming shock". For lesser degrees of hypothermia, recoverability depends more on the adequacy of supportive care than on the method of rewarming. The rapid and complete recovery experienced in the case presented is not surprising since the patient's premorbid condition was good, chilling had been rapid, metabolic exhaustion was mild, and internal rewarming was accomplished without delay, using heated peritoneal dialysis.