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Heat Illness and Hypothermia

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Pediatric Critical Care Medicine

Abstract

Children have impaired ability for effective thermoregulation. Environmental exposures and impaired intrinsic thermoregulation can lead to the catastrophic consequences from heat and cold injuries. The most severe form of heat related injury, heat stroke, involves extreme hyperthermia, neurologic impairment and progression to systemic inflammation, disseminated intravascular coagulation and multiple organ dysfunction syndrome (MODS). The mechanism of injury involves the inflammatory cascade, heat shock proteins, gut endotoxin translocation, and the systemic effects of direct thermal injury. Immediate rapid cooling and support of organ function are the mainstays of treatment. Accidental cold injuries commonly present with associated trauma. Regional frostbite and systemic deterioration are progressive with prolonged exposures. Predictable clinical sequelae including neurologic depression and eventual cardiopulmonary arrest occur if uninterrupted. Aggressive rewarming techniques including extracorporeal methods have the potential for excellent neurologic outcomes even in severe cases.

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Authors and Affiliations

  1. Division of Pediatric Critical Care, Naval Medical Center San Diego, San Diego, CA, USA

    Luke A. Zabrocki MD

  2. Division of Pediatric Critical Care, University of California, San Diego, San Diego, CA, USA

    David K. Shellington

  3. Department of Pediatrics, Primary Children’s Medical Center, Salt Lake City, UT, USA

    Susan L. Bratton

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  1. Luke A. Zabrocki MD
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  2. David K. Shellington
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  3. Susan L. Bratton
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Correspondence to Luke A. Zabrocki MD .

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Editors and Affiliations

  1. Div. of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

    Derek S. Wheeler

  2. Div. of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

    Hector R. Wong

  3. University of Michigan Medical School, Ann Arbor, Michigan, USA

    Thomas P. Shanley

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Zabrocki, L.A., Shellington, D.K., Bratton, S.L. (2014). Heat Illness and Hypothermia. In: Wheeler, D., Wong, H., Shanley, T. (eds) Pediatric Critical Care Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-6362-6_49

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