Tsuei Betty J, Kearney Paul A
Section of Trauma and Critical Care, Department of Surgery, University of Kentucky, 800 Rose Street, Room C-221, Lexington, KY 40536-0293, USA.
Injury. 2004 Jan;35(1):7-15. doi: 10.1016/s0020-1383(03)00309-7.
Hypothermia is a common finding in severely injured patients. Historically described as a consequence of wartime casualties where cold exposure was common, this topic has resurfaced in the trauma literature because of the increasing recognition of the morbidity and mortality associated with hypothermia. Hypothermia, along with acidosis and coagulopathy, has been identified as a component of the "lethal triad" in injured patients, and has been shown to contribute to increased mortality in these patients. Decreases in core temperature during the course of initial evaluation and resuscitation are common, and can contribute to poor outcomes in the injured patient. As induced hypothermia has been shown to be beneficial in some clinical situations, recent animal studies have attempted to investigate whether hypothermia in the trauma patient has any beneficial effects. This review examines the incidence and pathophysiology of hypothermia, and discusses mechanisms of heat loss and rewarming techniques that can be utilized in the trauma patient.
体温过低在重伤患者中很常见。历史上，体温过低被描述为战时伤亡的一个后果，当时寒冷暴露很常见，由于对与体温过低相关的发病率和死亡率的认识不断提高，这个话题在创伤文献中再次出现。体温过低与酸中毒和凝血功能障碍一起，已被确定为受伤患者“致死三联征”的一个组成部分，并已被证明会导致这些患者死亡率增加。在初始评估和复苏过程中，核心体温下降很常见，并且会导致受伤患者预后不良。由于诱导性体温过低已被证明在某些临床情况下有益，最近的动物研究试图调查创伤患者的体温过低是否有任何有益影响。这篇综述研究了体温过低的发生率和病理生理学，并讨论了创伤患者可采用的热量散失机制和复温技术。
