Infections in Hypothermic Patients

Lewin, Sharon R

doi:10.1001/archinte.1981.00340070100020

Cited by 26 publications

(4 citation statements)

References 16 publications

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“…Sepsis —Sepsis is common in patients with hypothermia, but it can be difficult to detect because the classic features may not be present 10. Broad spectrum antibiotics may be indicated if you suspect sepsis, even if it is not clinically obvious 10…”

Section: Other Important Management Considerationsmentioning

confidence: 99%

Accidental hypothermia

Epstein

Anna

2006

BMJ

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Section: Other Important Management Considerationsmentioning

confidence: 99%

Accidental hypothermia

Epstein

Anna

2006

BMJ

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“…Patients with marked hypothermia are at increased risk for the development of severe infections. Those individuals with prolonged exposure to the cold with resulting hypothermia frequently develop infections which may be occult since they fail to manifest typical signs of infection (23). However, many of these patients also suffered from chronic alcoholism with impaired cerebral function so the risk of infection may not be solely related to the hypothermia.…”

Section: Clinical Observationsmentioning

confidence: 99%

Hypothermia and Sepsis

Daniel¹

2006

Front Biosci

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Alterations in body temperature may be frequently observed in patients and experimental animals. Systemic infections may alter the host body temperature, and a pre-existing altered body temperature may modulate the host response to infection. Septic patients who develop hypothermia have a significantly worse outcome than those who develop a fever or maintain a normal body temperature. Perioperative hypothermia may occur as a result from anesthetic action, surgical procedures, or specific targeted interventions. This perioperative hypothermia is associated with adverse outcomes including increased surgical wound infections. In animal models of sepsis, perioperative hypothermia is also associated with a worse outcome and specific alterations of the inflammatory response. Understanding the mechanisms of why the host response to infection is impaired by pre-existing hypothermia will both improve our basic understanding of disease as well as identify potential targets for modulation.

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“…In addition, periodic hyperinflation [69] and attention to pulmonary toilet have been shown to decrease the incidence of pneumonia in hypothermic patients. Some investigators [20,124] have advocated that antibiotics should be given prophylactically because nearly all patients develop pneumonia. However, the efficacy of this approach has not been demonstrated and should be challenged for several reasons.…”

Section: Treatmentmentioning

confidence: 99%

Disorders of Temperature Control: Hypothermia, Part III

Curley

Irwin

1986

J Intensive Care Med

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Hypothermia, defined as a body core temperature below 35°C, results from exposure to cold, drugs, metabolic dysfunction, or nervous system or skin disorders. The diagnosis and clinical assessment of patients with hypothermia should be based on a thorough knowledge of the characteristic physiologic changes that accompany hypothermia and affect all organ systems. Morbidity and mortality resulting from hypothermia may be reduced when physicians anticipate the well-known complications of hypothermia and carefully rewarm the patient.The rate and method of rewarming must be individualized, taking into account available resources and the patient's cardiopulmonary status and underlying disease.In Parts I and II of this review, the normal physiology of temperature regulation and three hvperthermic syndromes-heat stroke, malignant hyperthermia, and neuroleptic malignant syndrome-were reviewed. This section focuses on unintentional hypothermia and reviews in detail its pathogenesis, pathophysiologic factors, diagnosis, and management. Iatrogenic and intentional hypothermia in the perioperative setting is briefly discussed.Hypothermia, defined as a core temperature below 35°C, is not uncommon; it occurs at all ambient temperatures and in patients of all ages, although more commonly in the elderly. During the winter in Great Britain, 0.7% of all hospital admissions [1], 3% of elderly patients admitted [2], and at least 10% of otherwise healthy elderly individuals examined at home [3] had core temperatures in the hypothermic range. Review of death certificates in the United States reveals an average mortality rate for hypothermia of 0.22 per 100,000 individuals; white women have the lowest rates, and nonwhite men, the highest [4]. When all data are reviewed, the overall mortality from hypothermia in the United States has been conservatively estimated at 17 deaths per million of the general population peryear {5]. The mortality rate for treated hypothermia ranges from 12% [6] to 73% [7]. Cause and PathogenesisAlthough hypothermia can occur in all climates, at nearly all ambient temperatures, and at every age, the most frequent causes (vide infra) appear to be exposure, use of depressant drugs, and hypoglycemia. The elderly, because of a &dquo;normal&dquo; impairment of regulatory function, constitute a large portion of the patients who become hypothermic. A brief review of the causes of hypothermia (Table 1) at UNIVERSITE LAVAL on July 1, 2015 jic.sagepub.com Downloaded from 271 Table 1. Causes of Hypothermia and their pathogenesis will help develop a rational approach to treatment.Exposure to Cold Fatal hypothermia occurs frequently, even in the healthy young adult who simply has been overexposed to the elements. Wet, wind, and exhaustion contribute to increased loss of body heat. Wet clothing loses 90% of its insulating value [8], rendering soaked individuals effectively nude. Exposure to rain or snow was believed to contribute greatly to the development of hypothermia in 15 of 23 incidents in hikers discussed in one rev...

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Infections in Hypothermic Patients

Cited by 26 publications

References 16 publications

Accidental hypothermia

Accidental hypothermia

Hypothermia and Sepsis

Disorders of Temperature Control: Hypothermia, Part III

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