Abstract

Numerous multiple trauma and surgical patients suffer from accidental hypothermia. While induced hypothermia is commonly used in elective cardiac surgery due to its protective effects, accidental hypothermia is associated with increased posttraumatic complications and even mortality in severely injured patients. This paper focuses on protective molecular mechanisms of hypothermia on apoptosis and the posttraumatic immune response. Although information regarding severe trauma is limited, there is evidence that induced hypothermia may have beneficial effects on the posttraumatic immune response as well as apoptosis in animal studies and certain clinical situations. However, more profound knowledge of mechanisms is necessary before randomized clinical trials in trauma patients can be initiated.

Highlights

  • A great number of patients with major injuries [1,2,3] suffer from accidental hypothermia ranging from 12 to 66% [4, 5]

  • While induced hypothermia is commonly used in elective cardiac surgery due to its protective effects, accidental hypothermia is associated with increased posttraumatic complications and even mortality in severely injured patients

  • This paper focuses on protective molecular mechanisms of hypothermia on apoptosis and the posttraumatic immune response

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Summary

Introduction

A great number of patients with major injuries [1,2,3] suffer from accidental hypothermia ranging from 12 to 66% [4, 5]. Thereby, the extent of hypothermia correlates with the overall injury severity and is increased by pelvic or abdominal surgery [7]; hypothermic polytrauma patients suffer from an increased incidence of posttraumatic complications [2, 4, 8,9,10] as well as a an increased mortality [2, 8, 11]. Accidental hypothermia is characterized by an unintentional decrease of the core temperature due to exposure to a cold environment without a thermoregulative dysfunction [12]. This can be aggravated by therapeutic interventions. This paper outlines the molecular mechanisms by which hypothermia influences apoptosis as well as the immune response following severe trauma and major surgery

Apoptosis
Immune System
Study design
Cellular Immune Response
Functional Parameters
Cooling Rewarming Procedure
Perspective
Full Text
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