VU University Medical Centre, De Boelelaan 1117, 1007 MB Amsterdam, The Netherlands.
Resuscitation. 2010 Nov;81(11):1550-5. doi: 10.1016/j.resuscitation.2010.05.023. Epub 2010 Aug 11.
Accidental hypothermia (AH) is a complex and life threatening condition. Knowledge about epidemiology, rewarming treatments, complications and outcome is limited. This study was initiated to obtain data on causes, rewarming treatments and complications.
A retrospective cohort study of all patients with a body temperature ≤ 35°C admitted to the Emergency Department (ED) of the VU university medical centre, Amsterdam, The Netherlands, between January 1, 2000 and August 31, 2008. A predefined set of epidemiological and clinical data was retrieved.
Eighty-four patients were included (median age: 47 years). Categories of hypothermia included immersion (18), submersion (29) and exposure to cold (37); concomitant factors were intoxication (26), trauma (40) and homelessness (7). Temperature at admission in the ED was 31.6 ± 2.6°C (mean ± SD), lowest temperature 24.2°C. Fourteen different rewarming treatments were used resulting in a wide range of rewarming speeds. Seventy-nine complications occurred: pulmonary, renal and neurological complications in 20, 17 and 10 patients respectively. Seventeen patients had 2 or more late complications. Twenty-four patients (28.6%) died: 10 during rewarming and 14 after rewarming was completed. Prognosis was poor in older and colder patients and after indoor exposure and submersion.
AH is a rare diagnosis in an inhomogeneous population, treated with a large variety of rewarming techniques. Most complications and death occurred late, after rewarming was completed. Because individual teams gain little clinical experiences, we suggest multiple centre data collection as a first step towards an evidence-based standard of care.
意外低体温（AH）是一种复杂且危及生命的病症。有关其流行病学、复温治疗、并发症和预后的数据有限。本研究旨在获取有关病因、复温治疗和并发症的数据。
对 2000 年 1 月 1 日至 2008 年 8 月 31 日期间因体温≤35°C 入住荷兰阿姆斯特丹 VU 大学医学中心急诊部的所有患者进行回顾性队列研究。检索了一组预定义的流行病学和临床数据。
共纳入 84 例患者（中位年龄：47 岁）。低体温类别包括浸泡（18 例）、淹没（29 例）和暴露于寒冷（37 例）；并发因素包括中毒（26 例）、创伤（40 例）和无家可归（7 例）。急诊部入院时的体温为 31.6±2.6°C（平均值±标准差），最低体温为 24.2°C。使用了 14 种不同的复温治疗方法，导致复温速度差异较大。发生了 79 种并发症：20 例患者出现肺部、肾脏和神经系统并发症，17 例和 10 例患者分别出现 17 例和 10 例并发症。17 例患者有 2 种或以上的迟发性并发症。24 例患者（28.6%）死亡：10 例在复温期间，14 例在复温完成后。老年人和体温较低的患者，以及在室内暴露和淹没的患者预后较差。
AH 在异质人群中是一种罕见的诊断，采用了多种复温技术进行治疗。大多数并发症和死亡发生在复温完成后晚期。由于各团队获得的临床经验有限，我们建议多中心数据收集作为迈向循证护理标准的第一步。
