%0 Journal Article
%T Current Management of Hypothermia: From Theory to Application
%A Ersin Demirer
%A Christian Ghattas
%A Hossam Abdel Rahman
%A Elamin Elamin
%J Respiratory Case Reports
%D 2013
%I LookUs Scientific
%R 10.5505/respircase.2012.36844
%X Objectives:To systematically review the literature on the current data in managing accidental hypothermia victims in the pre-hospital and hospital settings.Methods:We identified studies published from 1 January 1977 through 31 May 2012 by searching the MEDLINE, EMBASE and CINAHL and database of the National Library of Medicine. In addition, hand search of the bibliographies of retrieved articles in order to find additional sources was also performed. Initial search terms were 'definition of hypothermia', 'prehospital management', 'hospital management', and 'rewarming techniques' ''. We used standardized abstraction instruments to extract data on study characteristics, hierarchy of research design, study quality, risk factors, and laboratory predictors.Findings:Accidental hypothermia occurs due to body heat redistribution between core and peripheral tissues as well as imbalance between heat loss and production. Hypothermia may develop within a few minutes after immersion in cold water or exposure to cold weather. However, in debilitated victims or in the elderly it can occur slowly over many days by continuous exposure to milder cold temperature. The prognosis in accidental hypothermia depends to great extent on the degree and duration of the hypothermia, patient's premorbid condition, and the degree of exhaustion and metabolic derangement that result from the physiologic attempts to compensate for the heat loss.Interpretations and implications:Several studies demonstrated that the rapid and adequate recovery of the hypothermia victims depends on a well orchestrated management strategy both at the pre- and in- hospital levels. Management of deep hypothermia require rapid internal rewarming in order to support body core organs but all possible precautions should be undertaken to minimize the risk of "rewarming shock". On the other hand, for lesser degrees of hypothermia, recoverability depends more on the adequacy of hospital supportive care than on the method of rewarming. Such care require a medical team with very well understanding of the pathophysiologic that accompanied hypothermia and the implications of various treatment strategies.
%K hypothermia
%K prehospital management
%K hospital management
%K rewarming techniques
%U www.journalagent.com/z4/download_fulltext.asp?pdir=respircase&plng=tur&un=RCR-36844