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Accidental Hypothermia

The Experts below are selected from a list of 264 Experts worldwide ranked by ideXlab platform

Frank Hildebrand – 1st expert on this subject based on the ideXlab platform

  • effects of Accidental Hypothermia on posttraumatic complications and outcome in multiple trauma patients
    Injury-international Journal of The Care of The Injured, 2013
    Co-Authors: Philipp Mommsen, Hagen Andruszkow, Cornelia Fromke, Christian Zeckey, U Wagner, M Van Griensven, Michael Frink, Christian Krettek, Frank Hildebrand

    Abstract:

    Abstract Introduction Accidental Hypothermia seems to predispose multiple trauma patients to the development of posttraumatic complications, such as Systemic Inflammatory Response Syndrome (SIRS), sepsis, Multiple Organ Dysfunction Syndrome (MODS), and increased mortality. However, the role of Accidental Hypothermia as an independent prognostic factor is controversially discussed. The aim of the present study was to evaluate the incidence of Accidental Hypothermia in multiple trauma patients and its effects on the development of posttraumatic complications and mortality. Patients and methods Inclusion criteria for patients in this retrospective study (2005–2009) were an Injury Severity Score (ISS) ≥16, age ≥16 years, admission to our Level I trauma centre within 6 h after the accident. Accidental Hypothermia was defined as body temperature less than 35 °C measured within 2 h after admission, but always before first surgical procedure in the operation theatre. The association between Accidental Hypothermia and the development of posttraumatic complications as well as mortality was investigated. Statistical analysis was performed with χ2-test, Student’s t-test, ANOVA and logistic regression. Statistical significance was considered at p  Results 310 multiple trauma patients were enrolled in the present study. Patients’ mean age was 41.9 (SD 17.5) years, the mean injury severity score was 29.7 (SD 10.2). The overall incidence of Accidental Hypothermia was 36.8%. The overall incidence of posttraumatic complications was 77.4% (SIRS), 42.9% (sepsis) and 7.4% (MODS), respectively. No association was shown between Accidental Hypothermia and the development of posttraumatic complications. Overall, 8.7% died during the posttraumatic course. Despite an increased mortality rate in hypothermic patients, Hypothermia failed to be an independent risk factor for mortality in multivariate analysis. Conclusions Accidental Hypothermia is very common in multiply injured patients. However, it could be assumed that the increase of mortality in hypothermic patients is primarily caused by the injury severity and does not reflect an independent adverse effect of Hypothermia. Furthermore, Hypothermia was not shown to be an independent risk factor for posttraumatic complications.

  • Accidental Hypothermia in multiple trauma patients
    Zentralblatt Fur Chirurgie, 2012
    Co-Authors: Philipp Mommsen, Christian Zeckey, Michael Frink, Christian Krettek, Frank Hildebrand

    Abstract:

    BACKGROUND: Hypothermia, defined as a body core temperature below 35 °C, could be divided into an endogeneous, therapeutic and Accidental Hypothermia. At admission in the emergency room multiple trauma patients show a hypothermic core temperature in up to 66 %. A core temperature below 34 °C seems to be critical in these patients as this temperature limit has been demonstrated to be associated with an increased risk for post-traumatic complications and a decreased survival. In polytraumatised patients with a core temperature below 32 °C a mortality rate of 100 % has been described. MATERIAL AND METHODS: The main pathophysio-log-ical effects of Hypothermia concern the haemo-dynamic, coagulatory and immune systems. Mild Hypothermia (35-32 °C) leads to a vasoconstric-tion, tachycardia and increased cardiac output. After an increasing arrhythmia and bradycardia severe Hypothermia ( 0.5 °C / h) has been reported to be associated with an increased mortality during the further course, this procedure should only be applied in hypothermic multiple trauma patients with haemorrhagic shock. CONCLUSION: Accidental Hypothermia represents a serious problem in multiple trauma patients due to its frequency and negative pathophysiological effects. Therefore, early and effective re-warm-ing is essential in the treatment of hypothermic trauma patients. Possible protective effects of a therapeutic Hypothermia in the treatment of trauma patients after initial resuscitation and operative bleeding control have to be clarified in further experimental and clinical studies. Language: de

Philipp Mommsen – 2nd expert on this subject based on the ideXlab platform

  • effects of Accidental Hypothermia on posttraumatic complications and outcome in multiple trauma patients
    Injury-international Journal of The Care of The Injured, 2013
    Co-Authors: Philipp Mommsen, Hagen Andruszkow, Cornelia Fromke, Christian Zeckey, U Wagner, M Van Griensven, Michael Frink, Christian Krettek, Frank Hildebrand

    Abstract:

    Abstract Introduction Accidental Hypothermia seems to predispose multiple trauma patients to the development of posttraumatic complications, such as Systemic Inflammatory Response Syndrome (SIRS), sepsis, Multiple Organ Dysfunction Syndrome (MODS), and increased mortality. However, the role of Accidental Hypothermia as an independent prognostic factor is controversially discussed. The aim of the present study was to evaluate the incidence of Accidental Hypothermia in multiple trauma patients and its effects on the development of posttraumatic complications and mortality. Patients and methods Inclusion criteria for patients in this retrospective study (2005–2009) were an Injury Severity Score (ISS) ≥16, age ≥16 years, admission to our Level I trauma centre within 6 h after the accident. Accidental Hypothermia was defined as body temperature less than 35 °C measured within 2 h after admission, but always before first surgical procedure in the operation theatre. The association between Accidental Hypothermia and the development of posttraumatic complications as well as mortality was investigated. Statistical analysis was performed with χ2-test, Student’s t-test, ANOVA and logistic regression. Statistical significance was considered at p  Results 310 multiple trauma patients were enrolled in the present study. Patients’ mean age was 41.9 (SD 17.5) years, the mean injury severity score was 29.7 (SD 10.2). The overall incidence of Accidental Hypothermia was 36.8%. The overall incidence of posttraumatic complications was 77.4% (SIRS), 42.9% (sepsis) and 7.4% (MODS), respectively. No association was shown between Accidental Hypothermia and the development of posttraumatic complications. Overall, 8.7% died during the posttraumatic course. Despite an increased mortality rate in hypothermic patients, Hypothermia failed to be an independent risk factor for mortality in multivariate analysis. Conclusions Accidental Hypothermia is very common in multiply injured patients. However, it could be assumed that the increase of mortality in hypothermic patients is primarily caused by the injury severity and does not reflect an independent adverse effect of Hypothermia. Furthermore, Hypothermia was not shown to be an independent risk factor for posttraumatic complications.

  • Accidental Hypothermia in multiple trauma patients
    Zentralblatt Fur Chirurgie, 2012
    Co-Authors: Philipp Mommsen, Christian Zeckey, Michael Frink, Christian Krettek, Frank Hildebrand

    Abstract:

    BACKGROUND: Hypothermia, defined as a body core temperature below 35 °C, could be divided into an endogeneous, therapeutic and Accidental Hypothermia. At admission in the emergency room multiple trauma patients show a hypothermic core temperature in up to 66 %. A core temperature below 34 °C seems to be critical in these patients as this temperature limit has been demonstrated to be associated with an increased risk for post-traumatic complications and a decreased survival. In polytraumatised patients with a core temperature below 32 °C a mortality rate of 100 % has been described. MATERIAL AND METHODS: The main pathophysio-log-ical effects of Hypothermia concern the haemo-dynamic, coagulatory and immune systems. Mild Hypothermia (35-32 °C) leads to a vasoconstric-tion, tachycardia and increased cardiac output. After an increasing arrhythmia and bradycardia severe Hypothermia ( 0.5 °C / h) has been reported to be associated with an increased mortality during the further course, this procedure should only be applied in hypothermic multiple trauma patients with haemorrhagic shock. CONCLUSION: Accidental Hypothermia represents a serious problem in multiple trauma patients due to its frequency and negative pathophysiological effects. Therefore, early and effective re-warm-ing is essential in the treatment of hypothermic trauma patients. Possible protective effects of a therapeutic Hypothermia in the treatment of trauma patients after initial resuscitation and operative bleeding control have to be clarified in further experimental and clinical studies. Language: de

Jean Francois Payen – 3rd expert on this subject based on the ideXlab platform

  • neurologic recovery from profound Accidental Hypothermia after 5 hours of cardiopulmonary resuscitation
    Critical Care Medicine, 2014
    Co-Authors: Yvonnick Boue, Julien Lavolaine, Pierre Bouzat, Sophie Matraxia, Olivier Chavanon, Jean Francois Payen

    Abstract:

    Objective:To describe the successful neurologic recovery from profound Accidental Hypothermia with cardiac arrest despite the longest reported duration of cardiopulmonary resuscitation.Design:Case report.Setting:Mountain.Patient:A 57-year-old woman experienced profound Accidental Hypothermia (16.9°C