Akzidentelle Hypothermie: ein Update

Simon Rauch; Hermann Brugger; Peter Paal

doi:10.1055/a-0587-9463

Notfallmedizin up2date, Table of Contents

Notfallmedizin up2date 2018; 13(04): 431-444
DOI: 10.1055/a-0587-9463

Traumatologische und chirurgische Notfälle

Georg Thieme Verlag KG Stuttgart · New York

Akzidentelle Hypothermie: ein Update

Simon Rauch

,

Hermann Brugger

,

Peter Paal

Abstract

All articles of this category

In der Notfallmedizin muss mit dem Auftreten einer akzidentellen Hypothermie ganzjährig und auch in geschlossenen Räumen gerechnet werden. Eine Zunahme von sekundären Hypothermiefällen insbesondere bei älteren vorerkrankten Patienten ist im urbanen Umfeld zu beobachten. Die Körpertemperatur sollte als Vitalparameter bei jedem Notfallpatienten mit einem geeigneten Thermometer routinemäßig gemessen werden und wird bei einem Abfall auf < 35 °C als Hypothermie gewertet.

Schlüsselwörter

akzidentelle Hypothermie - Pathophysiologie - hypothermer Herz-Kreislauf-Stillstand

Full Text

References

Literatur
1 Brown DJ, Brugger H, Boyd J. et al. Accidental hypothermia. N Engl J Med 2012; 367: 1930-1938
2 Sakurada S, Shido O, Sugimoto N. et al. Autonomic and behavioural thermoregulation in starved rats. J Physiol 2000; 526 Pt 2: 417-424
3 Tattersall GJ, Milsom WK. Transient peripheral warming accompanies the hypoxic metabolic response in the golden-mantled ground squirrel. J Exp Biol 2003; 206: 33-42
4 Romanovsky AA, Shido O, Sakurada S. et al. Endotoxin shock: thermoregulatory mechanisms. Am J Physiol 1996; 270: R693-R703
5 Fonseca MT, Rodrigues AC, Cezar LC. et al. Spontaneous hypothermia in human sepsis is a transient, self-limiting, and nonterminal response. J Appl Physiol 2016; 120: 1394-1401
6 Matsuyama T, Morita S, Ehara N. et al. Characteristics and outcomes of accidental hypothermia in Japan: the J-Point registry. Emerg Med J 2018; 35: 659-666
7 Miller JW, Danzl DF, Thomas DM. Urban accidental hypothermia: 135 cases. Ann Emerg Med 1980; 9: 456-461
8 Buchanan TA, Cane P, Eng CC. et al. Hypothermia is critical for survival during prolonged insulin-induced hypoglycemia in rats. Metabolism 1991; 40: 330-334
9 Madden CJ. Glucoprivation in the ventrolateral medulla decreases brown adipose tissue sympathetic nerve activity by decreasing the activity of neurons in raphe pallidus. Am J Physiol Regul Integr Comp Physiol 2012; 302: R224-R232
10 Mégarbane B, Axler O, Chary I. et al. Hypothermia with indoor occurrence is associated with a worse outcome. Intens Care Med 2000; 26: 1843-1849
11 Herity B, Daly L, Bourke GJ. et al. Hypothermia and mortality and morbidity. An epidemiological analysis. J Epidemiol Community Health 1991; 45: 19-23
12 Vassal T, Benoit-Gonin B, Carrat F. et al. Severe accidental hypothermia treated in an ICU: prognosis and outcome. Chest 2001; 120: 1998-2003
13 Brandstrom H, Johansson G, Giesbrecht GG. et al. Accidental cold-related injury leading to hospitalization in northern Sweden: an eight-year retrospective analysis. Scand J Trauma Resusc Emerg Med 2014; 22: 6
14 Hislop LJ, Wyatt JP, McNaughton GW. et al. Urban hypothermia in the west of Scotland. West of Scotland Accident and Emergency Trainees Research Group. BMJ 1995; 311: 725
15 Woodhouse P, Keatinge WR, Coleshaw SR. Factors associated with hypothermia in patients admitted to a group of inner city hospitals. Lancet 1989; 2: 1201-1205
16 MacDonell JE, Wrenn K. Hypothermia in the summer. South Med J 1991; 84: 804-805
17 Gallaher MM, Fleming DW, Berger LR. et al. Pedestrian and hypothermia deaths among Native Americans in New Mexico. Between bar and home. JAMA 1992; 267: 1345-1348
18 Marsigny B, Lecoq-Jammes F, Cauchy E. Medical mountain rescue in the Mont-Blanc massif. Wilderness Environ Med 1999; 10: 152-156
19 Schober A, Sterz F, Handler C. et al. Cardiac arrest due to accidental hypothermia-a 20 year review of a rare condition in an urban area. Resuscitation 2014; 85: 749-756
20 Paal P, Rauch S. Indoor accidental hypothermia in the elderly: an emerging lethal entity in the 21st century. Emerg Med J 2018; 35: 667-668
21 Young AJ, Castellani JW. Exertion-induced fatigue and thermoregulation in the cold. Comp Biochem Physiol A Mol Integr Physiol 2001; 128: 769-776
22 Paal P, Gordon L, Strapazzon G. et al. Accidental hypothermia-an update : The content of this review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM). Scand J Trauma Resusc Emerg Med 2016; 24: 111
23 Prec O, Rosenman R. et al. The cardiovascular effects of acutely induced hypothermia. J Clin Invest 1949; 28: 293-300
24 Covino BG, DʼAmato HE. Mechanism of ventricular fibrillation in hypothermia. Circ Res 1962; 10: 148-155
25 Bjornstad H, Tande PM, Refsum H. Cardiac electrophysiology during hypothermia. Implications for medical treatment. Arctic Med Res 1991; 50 (Suppl. 06) 71-75
26 Vassallo SU, Delaney KA, Hoffman RS. et al. A prospective evaluation of the electrocardiographic manifestations of hypothermia. Acad Emerg Med 1999; 6: 1121-1126
27 Darocha T, Sobczyk D, Kosinski S. et al. Electrocardiographic Changes Caused by Severe Accidental Hypothermia. J Cardiothorac Vasc Anesth 2015; 29: e83-e86
28 Kanna B, Wani S. Giant J wave on 12-lead electrocardiogram in hypothermia. Ann Noninvasive Electrocardiol 2003; 8: 262-265
29 Maaravi Y, Weiss AT. The effect of prolonged hypothermia on cardiac function in a young patient with accidental hypothermia. Chest 1990; 98: 1019-1020
30 Pasquier M, Zurron N, Weith B. et al. Deep accidental hypothermia with core temperature below 24° presenting with vital signs. High Alt Med Biol 2014; 15: 58-63
31 Danzl DF, Pozos RS. Accidental hypothermia. N Engl J Med 1994; 331: 1756-1760
32 Severinghaus JW. Respiration and hypothermia. Ann NY Acad Sci 1959; 80: 384-394
33 Strapazzon G, Nardin M, Zanon P. et al. Respiratory failure and spontaneous hypoglycemia during noninvasive rewarming from 24.7°C (76.5°F) core body temperature after prolonged avalanche burial. Ann Emerg Med 2012; 60: 193-196
34 DʼAmato HE, Hegnauer AH. Blood volume in the hypothermic dog. Am J Physiol 1953; 173: 100-102
35 Buse S, Blancher M, Viglino D. et al. The impact of hypothermia on serum potassium concentration: A systematic review. Resuscitation 2017; 118: 35-42
36 Guyton AC. Transport of Oxygen and Carbon Dioxide in the Blood and Body Fluids. In: Textbook of medical Physiology, 8th edn. Philadelphia: Saunders; 1991: 433-443
37 Rohrer MJ, Natale AM. Effect of hypothermia on the coagulation cascade. Crit Care Med 1992; 20: 1402-1405
38 Wang HE, Callaway CW, Peitzman AB. et al. Admission hypothermia and outcome after major trauma. Crit Care Med 2005; 33: 1296-1301
39 Durrer B, Brugger H, Syme D. et al. The medical on-site treatment of hypothermia: ICAR-MEDCOM recommendation. High Altitude Med Biol 2003; 4: 99-103
40 Bristow GK, Giesbrecht GG. Contribution of exercise and shivering to recovery from induced hypothermia (31.2 degrees C) in one subject. Aviat Space Environ Med 1988; 59: 549-552
41 Hildebrand F, Giannoudis PV, van Griensven M. et al. Pathophysiologic changes and effects of hypothermia on outcome in elective surgery and trauma patients. Am J Surg 2004; 187: 363-371
42 Strapazzon G, Procter E, Paal P. et al. Pre-hospital core temperature measurement in accidental and therapeutic hypothermia. High Altitude Med Biol 2014; 15: 104-111
43 Darocha T, Kosinski S, Jarosz A. et al. Severe accidental hypothermia center. Eur J Emerg Med 2015; 22: 288-291
44 Kosinski S, Darocha T, Galazkowski R. et al. Accidental hypothermia in Poland – estimation of prevalence, diagnostic methods and treatment. Scand J Trauma Resusc Emerg Med 2015; 23: 13
45 Brugger H, Oberhammer R, Adler-Kastner L. et al. The rate of cooling during avalanche burial; a “Core” issue. Resuscitation 2009; 80: 956-958
46 Walpoth BH, Galdikas J, Leupi F. et al. Assessment of hypothermia with a new “tympanic” thermometer. J Clin Monit 1994; 10: 91-96
47 Strapazzon G, Procter E, Putzer G. et al. Influence of low ambient temperature on epitympanic temperature measurement: a prospective randomized clinical study. Scand J Trauma Resusc Emerg Med 2015; 23: 90
48 Durrer B, Brugger H, Syme D. Advanced challenges in resuscitation: special challenges in EEC-hypothermia. Resuscitation 2001; 50: 243-244
49 Grissom CK, McAlpine JC, Harmston CH. et al. Hypercapnia effect on core cooling and shivering threshold during snow burial. Aviat Space Environ Med 2008; 79: 735-742
50 Durrer B, Brugger H, Syme D. et al. The medical on-site treatment of hypothermia: ICAR-MEDCOM recommendation. High Alt Med Biol 2003; 4: 99-103
51 Danzl D. Accidental Hypothermia. In: Auerbach P, Cushing T, Harris S. eds. Wilderness Medicine. New York: Elsevier; 2016
52 Striebel HW, Steinhoff U, Krause H. et al. Die Zuverlässigkeit der pulsoximetrischen Überwachung der arteriellen Sauerstoffsättigung bei zentralisierten und hypothermen Patienten. Anasth Intensivther Notfallmed 1988; 23: 200-204
53 Clayton DG, Webb RK, Ralston AC. et al. A comparison of the performance of 20 pulse oximeters under conditions of poor perfusion. Anaesthesia 1991; 46: 3-10
54 Zafren K, Giesbrecht GG, Danzl DF. et al. Wilderness Medical Society practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia: 2014 update. Wilderness Environ Med 2014; 25: S66-S85
55 Caldwell JE, Heier T, Wright PM. et al. Temperature-dependent pharmacokinetics and pharmacodynamics of vecuronium. Anesthesiology 2000; 92: 84-93
56 Heier T, Caldwell JE. Impact of hypothermia on the response to neuromuscular blocking drugs. Anesthesiology 2006; 104: 1070-1080
57 Leslie K, Sessler DI, Bjorksten AR. et al. Mild hypothermia alters Propofol pharmacokinetics and increases the duration of action of Atracurium. Anesth Analg 1995; 80: 1007-1014
58 Marland S, Ellerton J, Andolfatto G. et al. Ketamine: use in anesthesia. CNS Neurosci Ther 2013; 19: 381-389
59 Matsukawa T, Kurz A, Sessler DI. et al. Propofol linearly reduces the vasoconstriction and shivering thresholds. Anesthesiology 1995; 82: 1169-1180
60 Sessler DI. Thermoregulatory defense mechanisms. Crit Care Med 2009; 37: S203-S210
61 Darocha T, Kosinski S, Jarosz A. et al. Should capnography be used as a guide for choosing a ventilation strategy in circulatory shock caused by severe hypothermia? Observational case-series study. Scand J Trauma Resusc Emerg Med 2017; 25: 15
62 Lloyd EL, Croxton D. Equipment for the provision of airway warming (insulation) in the treatment of accidental hypothermia in patients. Resuscitation 1981; 9: 61-65
63 Plaisier BR. Thoracic lavage in accidental hypothermia with cardiac arrest-report of a case and review of the literature. Resuscitation 2005; 66: 99-104
64 Weinberg AD. Hypothermia. Ann Emerg Med 1993; 22: 370-377
65 Truhlar A, Deakin CD, Soar J. et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances. Resuscitation 2015; 95: 148-201
66 Paal P, Milani M, Brown D. et al. Termination of cardiopulmonary resuscitation in mountain rescue. High Alt Med Biol 2012; 13: 200-208
67 Gilbert M, Busund R, Skagseth A. et al. Resuscitation from accidental hypothermia of 13.7 degrees C with circulatory arrest. Lancet 2000; 355: 375-376
68 Niazi SA, Lewis FJ. Profound hypothermia in man; report of a case. Ann Surg 1958; 147: 264-266
69 Odegaard S, Olasveengen T, Steen PA. et al. The effect of transport on quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest. Resuscitation 2009; 80: 843-848
70 Putzer G, Braun P, Zimmermann A. et al. LUCAS compared to manual cardiopulmonary resuscitation is more effective during helicopter rescue-a prospective, randomized, cross-over manikin study. Am J Emerg Med 2012; 31: 384-389
71 Gordon L, Paal P, Ellerton JA. et al. Delayed and intermittent CPR for severe accidental hypothermia. Resuscitation 2015; 90: 46-49
72 Krismer AC, Lindner KH, Kornberger R. et al. Cardiopulmonary resuscitation during severe hypothermia in pigs: does epinephrine or vasopressin increase coronary perfusion pressure?. Anesth Analg 2000; 90: 69-73
73 Kornberger E, Lindner KH, Mayr VD. et al. Effects of epinephrine in a pig model of hypothermic cardiac arrest and closed-chest cardiopulmonary resuscitation combined with active rewarming. Resuscitation 2001; 50: 301-308
74 Stoner J, Martin G, OʼMara K. et al. Amiodarone and bretylium in the treatment of hypothermic ventricular fibrillation in a canine model. Acad Emerg Med 2003; 10: 187-191
75 Walpoth BH, Walpoth-Aslan BN, Mattle HP. et al. Outcome of survivors of accidental deep hypothermia and circulatory arrest treated with extracorporeal blood warming. N Engl J Med 1997; 337: 1500-1505
76 Ruttmann E, Weissenbacher A, Ulmer H. et al. Prolonged extracorporeal membrane oxygenation-assisted support provides improved survival in hypothermic patients with cardiocirculatory arrest. J Thorac Cardiovasc Surg 2007; 134: 594-600
77 Forti A, Brugnaro P, Rauch S. et al. Hypothermic cardiac arrest with full neurologic recovery after approximately nine hours of cardiopulmonary resuscitation: management and possible complications. Ann Emerg Med 2018; pii:S0196-0644(18)31278-2
78 Lexow K. Severe accidental hypothermia: survival after 6 hours 30 minutes of cardiopulmonary resuscitation. Arctic Med Res 1991; 50 (Suppl. 06) 112-114
79 Pasquier M, Hugli O, Paal P. et al. Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: The HOPE score. Resuscitation 2018; 126: 58-64
80 Brugger H, Durrer B, Adler-Kastner L. et al. Field management of avalanche victims. Resuscitation 2001; 51: 7-15