Pathophysiology of accidental hypothermia

QJM: An International Journal of Medicine

Volumn 95, Issue 12, 2002, Pages 775-785

  Mallet, Mark L ^a  

^a ROYAL UNITED HOSPITAL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ALCOHOL; ALPHA ADRENERGIC RECEPTOR BLOCKING AGENT; BARBITURIC ACID DERIVATIVE; BENZODIAZEPINE DERIVATIVE; FIBRINOGEN; LITHIUM; OPIATE DERIVATIVE; PHENOTHIAZINE; PRAZOSIN; TRICYCLIC ANTIDEPRESSANT AGENT;

ACCIDENTAL HYPOTHERMIA; AMNESIA; BLOOD VESSEL PERMEABILITY; BLOOD VISCOSITY; BODY TEMPERATURE; CARDIOVASCULAR SYSTEM; CONFUSION; DISEASE PREDISPOSITION; DIURESIS; ELDERLY CARE; GASTROINTESTINAL TRACT; HEART OUTPUT; HEAT LOSS; HEMATOCRIT; HEMATOLOGY; HUMAN; HYPERTENSION; INTESTINE MOTILITY; METABOLISM; NERVOUS SYSTEM; PATHOGENESIS; PATHOPHYSIOLOGY; PATIENT CARE; PRIORITY JOURNAL; RESPIRATORY SYSTEM; REVIEW; SEPSIS; SKIN RECEPTOR; TACHYCARDIA; TACHYPNEA; THERMOGENESIS; THERMOREGULATION; URINARY TRACT; VASOCONSTRICTION; WARMING; WATER IMMERSION;

EID: 0036928544     PISSN: 14602725     EISSN: None     Source Type: Journal    
DOI: 10.1093/qjmed/95.12.775     Document Type: Review

References (105)

1. Herity B, Daly L, Bourke GJ, Horgan JM. Hypothermia and mortality and morbidity: an epidemiological analysis. J Epid Comm Health 1991; 45:19-23.
2. Hislop LJ, Wyatt JP, McNaughton GW, Ireland AJ, Rainer TH, Olverman G, Laughton LM. Urban hypothermia in the west of Scotland. Br Med J 1995; 311:725.
3. Woodhouse P, Keatinge WR, Coleshaw SR. Factors associated with hypothermia in patients admitted to a group of inner city hospitals. Lancet 1989; 335:1201-5.
4. Gautam P, Ghosh S, Mandal A, Vargas E. Hypothermia in the elderly: sociomedical characteristics and outcome of 86 patients. Public Health 1989; 103:15-22.
5. Maclean D, Emslie-Smith. Accidental Hypothermia. Oxford, Blackwell Scientific, 1977.
6. Reuler JB. Hypothermia: pathophysiology, clinical settings, and management. Ann Intern Med 1978; 89:519-27.
7. Collins KJ, Dore C, Exton-Smith AN, Fox RH, MacDonald IC, Woodward PM. Accidental hypothermia and impaired temperature homoeostasis in the elderly. Br Med J 1977; 1:353-6.
8. Collins KJ, Exton-Smith AN, Dore C. Urban hypothermia: preferred temperature and thermal perception in old age. Br Med J 1981; 282:175-7.
9. Chan KM, Beard K. A patient with recurrent hypothermia associated with thrombocytopenia. Postgrad Med J 1993; 69:227-9.
10. Slotki IN, Oelbaum MH. Recurrent spontaneous hypothermia. Postgrad Med J 1980; 56:656-7.
11. Scott AR, MacDonald IA, Bennett T, Tattersall RB. Abnormal thermoregulation in diabetic autonomic neuropathy. Diabetes 1988; 37:961-8.
12. Freinkel N, Metzger BE, Harris E, Robinson S, Mager M. The hypothermia of hypoglycemia: studies with 2-deoxy-D-glucose in normal human subjects and mice. N Engl J Med 1972; 287:841-5.
13. Haight JS, Keatinge WR. Failure of thermoregulation in the cold during hypoglycaemia induced by exercise and alcohol. J Physiol 1973; 229:87-97.
14. Gale EA, Tattersall RB. Hypothermia: a complication of diabetic ketoacidosis. Br Med J 1978; 277:1387-9.
15. Neil HA, Dawson JA, Baker JE. Risk of hypothermia in elderly patients with diabetes. Br Med J 1986; 293:416-18.
16. Yokoyama M, Noto Y, Kida H. Hypothermia with acute renal failure in a patient suffering from diabetic nephropathy and malnutrition. Diabetes Metab 2000; 26:145-7.
17. Kramer MR, Vandijk J, Rosin AJ. Mortality in elderly patients with thermoregulatory failure. Arch Intern Med 1989; 149:1521-3.
18. Darowski A, Najim Z, Weinberg JR, Guz A. Hypothermia and infection in elderly patients admitted to hospital. Age Ageing 1991; 20:100-6.
19. Megarbane B, Axler O, Chary I, Pompier R, Brivet FG. Hypothermia with indoor occurrence is associated with a worse outcome. Intensive Care Med 2000; 26:1843-9.
20. Clemmer TP, Fisher CJ, Bone RC, Slotman GJ, Metz CA, Thomas FO. Hypothermia in the sepsis syndrome and clinical outcome. The Methylprednisolone Severe Sepsis Study Group. Crit Care Med 1992; 20:1395-401.
21. Arons MM, Wheeler AP, Bernard GR, Christman BW, Russell JA, Schein R, et al. Effects of ibuprofen on the physiology and survival of hypothermic sepsis. Ibuprofen in Sepsis Study Group. Crit Care Med 1999; 27:699-707.
22. Romanovsky AA, Simons CT, Szekely M, Kulchitsky VA. The vagus nerve in the thermoregulatory response tosystemic inflammation. Am J Physiol 1997; 273:R407-13.
23. Romanovsky AA, Shido O, Sakurada S, Sugimoto H, Nagasaka T. Endotoxin shock-associated hypothermia: how and why does it occur? Ann N Y Acad Sci 1997; 813:733-7.
24. Wong KC. Physiology and pharmacology of hypothermia. West J Med 1983; 138:227-232.
25. de Leeuw PW, Birkenhager WH. Hypothermia: a possible side effect of prazosin. Br Med J 1980; 281:1181.
26. Frank SM, Raja SN, Wu PK, el-Gamal N. Alpha-adrenergic mechanisms of thermoregulation in humans. Ann N Y Acad Sci 1997; 813:101-10.
27. Follezou JY, Bleibel JM. Reduction of temperature and lithium poisoning. N Engl J Med 1985; 313:1609.
28. Kalant H, Le AD. Effects of ethanol on thermoregulation. Pharmacol Ther 1983; 23:313-64.
29. Lomax P, Bajorek JG, Bajorek TA, Chaffee RR. Thermoregulatory mechanisms and ethanol hypothermia. Eur J Pharmacol 1981; 71:483-7.
30. Zachariah SB, Zachariah A, Ananda R, Stewart JT. Hypothermia and thermoregulatory derangements induced by valproic acid. Neurology 2000; 55:150-1.
31. Lloyd EL. Treatment of accidental hypothermia. Br Med J 1979; 278:413-14.
32. Lønning PE, Skulberg, Åbyholm F. Accidental hypothermia: review of the literature. Acta Anaesthesiol Scand 1986; 30:601-13.
33. Gunby P. Cold facts concerning hypothermia. JAMA 1980; 243:1403-9.
34. Roscher R, Arlock P, Sjoberg T, Steen S. Effects of dopamine on porcine myocardial action potentials and contractions at 37 degrees C and 32 degrees C. Acta Anaesthesiol Scand 2001; 45:421-6.
35. Morris DL, Chambers HF, Morris MG, Sande MA. Hemodynamic characteristics of patients with hypothermia due to occult infection and other causes. Ann Intern Med 1985; 102:153-7.
36. Reuler JB, Parker RA. Peritoneal dialysis in the management of hypothermia. JAMA 1978; 240:2289-90.
37. Vassallo SU, Delaney KA, Hoffman RS, Slater W, Goldfrank LR. A prospective evaluation of the electrocardiographic manifestations of hypothermia. Acad Emerg Med 1999; 6:1121-6.
38. Kiyosue T, Arita M, Muramatsu H, Spindler AJ, Noble D. Ionic mechanisms of action potential prolongation at low temperature in guinea-pig ventricular myocytes. J Physiol 1993; 468:85-106.
39. Solomon A, Barish RA, Browne B, Tso E. The electrocardiographic features of hypothermia. J Emerg Med 1989; 7:169-73.
40. Bashour TT, Gualberto A, Ryan C. Atrioventricular block in accidental hypothermia: a case report. Angiology 1989; 40:63-6.
41. Talbott JH. The physiologic and therapeutic effects of hypothermia. N Engl J Med 1941; 224:281-8.
42. Editorial. Treating accidental hypothermia. Br Med J 1978; 277:1383-4.
43. Nicolas F, Nicolas G, Baron D, Desjars P, Sollet JP. Circulatory and metabolic disturbances in accidental hypothermia. [Article in French] Bull Physiopathol Respir (Nancy) 1975; 11:757-85.
44. White DC, Hull NW. The effect of alcohol on the cardiac arrest temperature in hypothermic rats. Clin Sci 1965; 28:395-9.
45. Dixon RG, Dougherty JM, White LJ, Lombino D, Rusnak RR. Transcutaneous pacing in a hypothermic-dog model. Ann Emerg Med 1997; 29:602-6.
46. Southwick FS, Dalglish PH. Recovery after prolonged asystolic cardiac arrest in profound hypothermia. JAMA 1980; 243:1250-3.
47. Lloyd EL, Mitchell B. Factors affecting the onset of ventricular fibrillation in hypothermia: an hypothesis. Lancet 1974; 2:1294-6.
48. Bjørnstad H, Jenssen D, Mortensen E. Diltiazem does not increase ventricular fibrillation threshold during hypothermia. Acta Anaesthesiol Scand 1995; 39:659-65.
49. Lloyd EL. Accidental hypothermia. Resuscitation 1996; 32:111-24.
50. Thomas R, Cahill CJ. Successful defibrillation in profound hypothermia (core body temperature 25.6 degrees C). Resuscitation 2000; 47:317-20.
51. Nordrehaug JE. Sustained ventricular fibrillation in deep accidental hypothermia. Br Med J 1982; 284:867-8.
52. Dronen S, Nowak RM, Tomlanovich MC. Bretylium tosylate and hypothermic ventricular fibrillation. Ann Emerg Med 1980; 9:335.
53. Kochar G, Kahn SE, Kotler MN. Bretylium tosylate and ventricular fibrillation in hypothermia. Ann Intern Med 1986; 105:624.
54. Bjørnstad H, Mortensen E, Sager G, Refsum H. Effect of bretylium tosylate on ventricular fibrillation threshold during hypothermia in dogs. Am J Emerg Med 1994; 12:407-12.
55. Rankin AC, Rae AP. Cardiac arrhythmias during rewarming of patients with accidental hypothermia. Br Med J 1984; 289:874-7.
56. Hearse DJ, Yamamoto F, Shattaock MJ. Calcium antagonists and hypothermia: the temperature dependency of the negative inotropic and anti-ischemic properties of verapamil in the isolated rat heart. Circulation 1984; 70:154-64.
57. Chernow B, Lake CR, Zaritsky A, Finton CK, Casey L, Rainey TG, Fletcher JR. Sympathetic nervous system 'switch off' with severe hypothermia. Crit Care Med 1983; 11:677-80.
58. Maclean D, Griffiths PD, Emslie-Smith D. Serum-enzymes in relation to electrocardiographic changes in accidental hypothermia. Lancet 1968; 2:1266-70.
59. Hirvonen J. Necropsy findings in fatal hypothermia cases. Forensic Sci 1976; 8:155-64.
60. Danzl DF, Pozos RS. Accidental hypothermia. N Engl J Med 1994; 331:1756-60.
61. Rosenkranz L. Bone marrow failure and pancytopenia in two patients with hypothermia. South Med J 1985; 78:358-9.
62. O'Brien RC, Amess JAL, Mollin DL. Recurrent thrombocytopaenia, erythroid hypoplasia and sideroblastic anaemia associated with hypothermia. Br J Haematol 1982; 51:451-6.
63. Rohrer MJ, Natale AM. Effect of hypothermia on the coagulation cascade. Crit Care Med 1992; 20:1402-5.
64. Reed RL 2nd, Johnson TD, Hudson JD, Fischer RP. The disparity between hypothermic coagulopathy and clotting studies. J Trauma 1992; 33:465-70.
65. Breen EG, Coghlan JG, Egan E, McCarthy CF. Impaired coagulation in accidental hypothermia of the elderly. Age Ageing 1988; 17:343-6.
66. Mahajan SL, Myers TJ, Baldini MG. Disseminated intravascular coagulation during rewarming following hypothermia. JAMA 1981; 245:2517-18.
67. Carden DL, Nowak RM. Disseminated intravascular coagulation in hypothermia. JAMA 1982; 247:2099.
68. Mikhailidis DP, Hutton RA, Jeremy JY, Dandona P. Hypothermia and pancreatitis. J Clin Pathol 1983; 36:483-4.
69. Easterbrook PJ, Davis HP. Thrombocytopenia in hypothermia: a common but poorly recognised complication. Br Med J 1985; 291:23.
70. Vella MA, Jenner C, Betteridge DJ, Jowett NI. Hypothermia-induced thrombocytopenia. J R Soc Med 1988; 81:228-9.
71. Michelson AD, MacGregor H, Barnard MR, Kestin AS, Rohrer MJ, Valeri CR. Reversible inhibition of human platelet activation by hypothermia in vivo and in vitro. Thromb Haemost 1994; 71:633-40.
72. Goodall HB, Todd AS, Maclean D, Henderson R, King JF. Proceedings: Cryofibrinogenaemia and activation of the coagulation/lysis systems in accidental hypothermia of the elderly. J Clin Pathol 1975; 28:758.
73. Maclean D. Emergency management of accidental hypothermia: a review. J R Soc Med 1986; 79:528-31.
74. Shenaq SA, Yawn DH, Saleem A, Joswiak R, Crawford ES. Effect of profound hypothermia on leukocytes and platelets. Ann Clin Lab Sci 1986; 16:130-3.
75. Biggar WD, Bohn DJ, Kent G, Barker C, Hamilton G. Neutrophil migration in vitro and in vivo during hypothermia. Infect Immun 1984; 46:857-9.
76. Akriotis V, Biggar WD. The effects of hypothermia on neutrophil function in vitro. J Leukoc Biol 1985; 37:51-61.
77. Moore FD Jr, Warner KG, Assousa S, Valeri CR, Khuri SF. The effects of complement activation during cardiopulmonary bypass: attenuation by hypothermia, heparin, and hemodilution. Ann Surg 1988; 208:95-103.
78. Althaus U, Aeberhard P, Schupbach P, Nachbur BH, Muhlemann W. Management of profound accidental hypothermia with cardiorespiratory arrest. Ann Surg 1982; 195:492-5.
79. Fischbeck KH, Simon RP. Neurological manifestations of accidental hypothermia. Ann Neurol 1981; 10:384-7.
80. Landowne D, Scruggs V. The temperature dependence of the movement of potassium and chloride ions associated with nerve impulses. J Physiol 1976; 259:145-58.
81. Katz B, Miledi R. The effect of temperature on the synaptic delay at the neuromuscular junction. J Physiol 1965; 181:656-70.
82. Bennett AF. Thermal dependence of muscle function. Am J Physiol 1984; 247:R217-29.
83. 2 in intact and carotid body-denervated awake rats. J Appl Physiol 1993; 75:2570-9.
84. Swain JA. Hypothermia and blood pH. Arch Intern Med 1988; 148:1643-6.
85. Atterhog JH, Carlens P, Granberg PO, Wallenberg LR. Cardiovascular and renal responses to acute cold exposure in water-loaded man. Scand J Clin Lab Invest 1975; 35:311-17.
86. McKean WI, Dixon SR, Gwynne JF, Irvine RO. Renal failure after accidental hypothermia. Br Med J 1970; 1:463-4.
87. Gibbs DH. Inhibition of corticotropin release during hypothermia: the role of corticotropin-releasing factor, vasopressin, and oxytocin. Endocrinology 1985; 116:723-7.
88. Felicetta JV, Green WL, Goodner CJ. Decreased adrenal responsiveness in hypothermic patients. J Clin Endocrinol Metab 1980; 50:93-7.
89. Woolf PD, Hollander CS, Mitsuma T, Lee LA, Schalch DS. Accidental hypothermia: endocrine function during recovery. J Clin Endocrinol Metab 1972; 34:460-6.
90. Curry DL, Curry KP. Hypothermia and insulin secretion. Endocrinology 1970; 87:750-5.
91. Maclean D, Griffiths PD, Browning MCK, Murison J. Metabolic aspects of spontaneous rewarming in accidental hypothermia and hypothermic myxoedema. Q J Med 1974; 43:371-87.
92. Stoner HB, Frayn KN, Little RA, Threlfall CJ, Yates DW, Barton RN, Heath DF. Metabolic aspects of hypothermia in the elderly. Clin Sci 1980; 59:19-27.
93. Koht A, Cane R, Cerullo LJ. Serum potassium levels during prolonged hypothermia. Intensive Care Med 1983; 9:275-7.
94. Levy LA. Severe hypophosphatemia as a complication of the treatment of hypothermia. Arch Intern Med 1980; 140:128-9.
95. Knochel JP. The pathophysiology and clinical characteristics of severe hypophosphatemia. Arch Intern Med 1977; 137:203-20.
96. Birchmeyer MS, Mitchell EK. Wischnewski revisited: the diagnostic value of gastric mucosal ulcers in hypothermic deaths. Am J Forensic Med Pathol 1989; 10:28-30.
97. Takada M, Kusano I, Yamamoto H, Shiraishi T, Yatani R, Haba K. Wischnevsky's gastric lesions in accidental hypothermia. Am J Forensic Med Pathol 1991; 12:300-5.
98. Takeuchi K, Suzuki K, Araki H, Mizoguchi H, Sugamoto S, Umdeda M. Roles of endogenous prostaglandins and nitric oxide in gastroduodenal ulcerogenic responses induced in rats by hypothermic stress. J Physiol Paris 1999; 93:423-31.
99. Zell SC, Kurtz KJ. Severe exposure hypothermia: a resuscitation protocol. Ann Emerg Med 1985; 14:339-45.
100. Foulis AK. Morphological study of the relation between accidental hypothermia and acute pancreatitis. J Clin Pathol 1982; 35:1244-8.
101. Maclean D, Murison J, Griffiths PD. Acute pancreatitis and diabetic ketoacidosis in accidental hypothermia and hypothermic myxoedema. Br Med J 1973; 4(895):757-61.
102. Savides EP, Hoffbrand BI. Hypothermia, thrombosis and acute pancreatitis. Br Med J 1974; 1:614.
103. Wolf DA, Aronson JF, Rajaraman S, Veasey SP. Wischnewski ulcers and acute pancreatitis in two hospitalized patients with cirrhosis, portal vein thrombosis, and hypothermia. J Forensic Sci 1999; 44:1082-5.
104. Hirano T, Manabe T, Imanishi K, Ando K. Direct surface cooling of the exocrine pancreas in the rat. Br J Surg 1992; 79:803-6.
105. Lloyd EL. Accidental hypothermia treated by central rewarming via the airway. Br J Anaesth 1973; 45:41-8.