Hypothermia in Trauma

Abstract

Objectives Provide a thorough understanding of the clinical impact of hypothermia in trauma patients. Provide a clinically useful guide to the differentiation between mild, moderate, and severe trauma-associated hypothermia. Present the current knowledge on prevention and treatment of hypothermia in trauma victims, with a special focus on critical bleeding. Understand the mechanisms and the diagnosis and treatment of accidental hypothermia with and without asphyxia. INTRODUCTION The anesthesiologist can play many important roles in the Trauma Chain of Survival (Figure 29.1). In some systems, the contribution of the anesthesiologist is limited to perioperative care, while in other systems the anesthesiologist acts both as a prehospital emergency physician, as a member of the hospital trauma team, and as a critical care physician. Independent of where and what role, hypothermia is a serious complication to trauma that deserves full attention by the anesthesiologist [1–3]. As hypothermia is generally considered detrimental for the patient, much focus has been on prevention. Despite this, hypothermia in trauma patients is still a common finding. There are many indications that hypothermia is still not managed in an optimal fashion [3, 4]. Based on promising animal results, some authors believe that rapidly induced extreme hypothermia (“hibernation”) may play a future role in severe hemorrhagic shock during transport to definitive surgical care [5]. So far, this laboratory research has not changed clinical practice and probably will not do so in the near future.