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Accidental Hypothermia

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Evidence-Based Critical Care

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Abstract

Accidental hypothermia, defined as a core temperature <35 °C secondary to unanticipated cold exposure, is prevalent in all geographic regions and carries significant morbidity and mortality. The adage that “a person is not dead until he is warm and dead” remains true and aggressive resuscitation is therefore indicated in nearly every patient who presents with accidental hypothermia. Unfortunately, no strong evidence-based guidelines exist as the literature surrounding optimal management consists almost exclusively of case reports. Still, the amount of information on the topic allows the provider to develop a rationale treatment plan specific to the patient’s presentation and available resources. This chapter will review the existing evidence surrounding the accurate diagnosis of accidental hypothermia, basics of rewarming strategies, appropriate selection of rewarming modality, and controversial aspects of management.

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Abbreviations

°C:

Degrees Celsius

ACLS:

Advanced Cardiac Life Support

AHA:

American Heart Association

CAVR:

Continuous arteriovenous rewarming

CPB:

Cardiopulmonary bypass

CPR:

Cardiopulmonary resuscitation

CVVHD:

Continuous venovenous hemodiafiltration

CVVR:

Continuous venovenous rewarming

CXR:

Chest x-ray

ECG:

Electrocardiogram

EMS:

Emergency Medicine Services

IV:

Intravenous

PRBC:

Packed red blood cells

VA-ECMO:

Venoarterial extracorporeal membrane oxygenation

VF:

Ventricular fibrillation

VT:

Ventricular tachycardia

VV-ECMO:

Venovenous extracorporeal membrane oxygenation

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA

    Carrie Harvey

  2. Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA

    Ivan Nathaniel Co

Authors
  1. Carrie Harvey
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  2. Ivan Nathaniel Co
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Correspondence to Carrie Harvey .

Editor information

Editors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, Michigan, USA

    Robert C. Hyzy

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Harvey, C., Co, I.N. (2017). Accidental Hypothermia. In: Hyzy, R. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-43341-7_9

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  • DOI: https://doi.org/10.1007/978-3-319-43341-7_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43339-4

  • Online ISBN: 978-3-319-43341-7

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