Accidental hypothermia in severe trauma

作者：Vardon Fanny; Mrozek Segolene; Geeraerts Thomas^*; Fourcade Olivier

来源：Anaesthesia Critical Care & Pain Medicine, 2016, 35(5): 355-361.

DOI：10.1016/j.accpm.2016.05.001

• Hypothermia
• Polytrauma
• Haemostasis
• Mortality
• Coagulopathy

Hypothermia, along with acidosis and coagulopathy, is part of the lethal triad that worsen the prognosis of severe trauma patients. While accidental hypothermia is easy to identify by a simple measurement, it is no less pernicious if it is not detected or treated in the initial phase of patient care. It is a multifactorial process and is a factor of mortality in severe trauma cases. The consequences of hypothermia are many: it modifies myocardial contractions and may induce arrhythmias; it contributes to trauma-induced coagulopathy; from an immunological point of view, it diminishes inflammatory response and increases the chance of pneumonia in the patient; it inhibits the elimination of anaesthetic drugs and can complicate the calculation of dosing requirements; and it leads to an over-estimation of coagulation factor activities. This review will detail the pathophysiological consequences of hypothermia, as well as the most recent principle recommendations in dealing with it.

• 出版日期2016-10