Division of Neonatology and Pediatric Critical Care Medicine, University Medical Center Eppendorf, 20246 Hamburg, Germany.
Int J Environ Res Public Health. 2021 Oct 31;18(21):11484. doi: 10.3390/ijerph182111484.
Hypothermia in pediatrics is mainly about small body size. The key thermal factor here is the large surface-to-volume ratio. Although small mammals, including human infants and children, are adapted to higher heat losses through their elevated metabolic rate and thermogenic capacity, they are still at risk of hypothermia because of a small regulatory range and an impending metabolic exhaustion. However, some small mammalian species (hibernators) use reduced metabolic rates and lowered body temperatures as adaptations to impaired energy supply. Similar to nature, hypothermia has contradictory effects in clinical pediatrics as well: In neonates, it is a serious risk factor affecting respiratory adaptation in term and developmental outcome in preterm infants. On the other hand, it is an important self-protective response to neonatal hypoxia and an evidence-based treatment option for asphyxiated babies. In children, hypothermia first enabled the surgical repair of congenital heart defects and promotes favorable outcome after ice water drowning. Yet, it is also a major threat in various prehospital and clinical settings and has no proven therapeutic benefit in pediatric critical care. All in all, pediatric hypothermia is an ambiguous issue whose harmful or beneficial effects strongly depend on the particular circumstances.
儿科低体温主要与体型小有关。这里的关键热因素是较大的体表-体积比。尽管包括人类婴儿和儿童在内的小型哺乳动物通过较高的代谢率和产热能力适应了更高的热量损失，但由于调节范围小和即将发生的代谢衰竭，它们仍有低体温的风险。然而，一些小型哺乳动物物种（冬眠动物）通过降低代谢率和体温来适应能量供应的减少。与自然界相似，低体温在儿科临床中也有矛盾的影响：在新生儿中，它是影响足月新生儿呼吸适应和早产儿发育结果的严重危险因素。另一方面，它是新生儿缺氧的重要自我保护反应，也是窒息婴儿的循证治疗选择。在儿童中，低体温首先使先天性心脏缺陷的手术修复成为可能，并促进冰水溺水后的良好结果。然而，它也是各种院前和临床环境中的主要威胁，并且在儿科危重病护理中没有被证实的治疗益处。总的来说，儿科低体温是一个模糊的问题，其有害或有益的影响强烈取决于特定情况。
