Hypothermia: Beyond the Narrative Review—The Point of View of Emergency Physicians and Medico-Legal Considerations

Author:

Savioli Gabriele1ORCID,Ceresa Iride Francesca2ORCID,Bavestrello Piccini Gaia3ORCID,Gri Nicole4,Nardone Alba5,La Russa Raffaele6,Saviano Angela7,Piccioni Andrea7ORCID,Ricevuti Giovanni8ORCID,Esposito Ciro9

Affiliation:

1. Emergency Department, IRCCS Policlinico San Matteo, 27100 Pavia, Italy

2. Emergency Department and Internal Medicine, Istituti Clinici di Pavia e Vigevano, Gruppo San Donato, 27029 Vigevano, Italy

3. Emergency Medicine, Université Libre de Bruxelles, 1050 Brussels, Belgium

4. Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell’Ospedale Maggiore, 3, 20162 Milano, Italy

5. Emergency Department, Ospedale Civile, 27058 Voghera, Italy

6. Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, 71122 Foggia, Italy

7. Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy

8. Department of Drug Science, University of Pavia, 27100 Pavia, Italy

9. Nephrology and Dialysis Unit, ICS Maugeri, University of Pavia, 27100 Pavia, Italy

Abstract

Hypothermia is a widespread condition all over the world, with a high risk of mortality in pre-hospital and in-hospital settings when it is not promptly and adequately treated. In this review, we aim to describe the main specificities of the diagnosis and treatment of hypothermia through consideration of the physiological changes that occur in hypothermic patients. Hypothermia can occur due to unfavorable environmental conditions as well as internal causes, such as pathological states that result in reduced heat production, increased heat loss or ineffectiveness of the thermal regulation system. The consequences of hypothermia affect several systems in the body—the cardiovascular system, the central and peripheral nervous systems, the respiratory system, the endocrine system and the gastrointestinal system—but also kidney function, electrolyte balance and coagulation. Once hypothermia is recognized, prompt treatment, focused on restoring body temperature and supporting vital functions, is fundamental in order to avert preventable death. It is important to also denote the fact that CPR has specificities related to the unique profile of hypothermic patients.

Publisher

MDPI AG

Subject

Medicine (miscellaneous)

Reference129 articles.

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4. QuickStats: Death Rates* Attributed to Excessive Cold or Hypothermia† Among Persons Aged ≥15 Years, by Urban-Rural Status§ and Age Group—National Vital Statistics System, United States, 2019;Spencer;MMWR Morb. Mortal. Wkly. Rep.,2021

5. van Veelen, M.J., and Brodmann Maeder, M. (2021). Hypothermia in Trauma. Int. J. Environ. Res. Public Health, 18.

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