Turner E, Radke J, Hilfiker O, Stafforst D, Braun U, Kettler D
Anaesthesist. 1984 Jul;33(7):311-5.
Two patients were rewarmed from hypothermia (esophageal temperature 27.2 degrees C, 27.5 degrees C respectively). The first case suffered from head-injury after alcohol ingestion and was deeply comatose. A metabolic or cardiovascular regulatory response to cold was not observed in this patient. The relationship between esophageal temperature and whole-body-oxygen consumption was quantified with a Q10 of 2.75 during rewarming (27.2-37.2 degrees C). His epinephrine levels were greatly elevated to 1,000 pg/ml whereas norepinephrine levels were only moderately increased to 250 pg/ml. Premature ventricular contractions (PVCs) during intubation or from the pulmonary artery catheter were not observed. The second patient was a 87 year old man with accidental hypothermia. He exhibited shivering at an esophageal temperature of 27.5 degrees C which indicated persistent thermoregulation. In contrast to the first case his norepinephrine levels were elevated to 1,500 pg/ml and his epinephrine levels only to 450 pg/ml. After onset of surface rewarming an additional increase in norepinephrine levels was observed and an increasing rate of PVC's (15/min) recorded, which ceased when temperature returned to normal. Our observations indicate that part of the cardiac complications during rewarming from deep hypothermia may result from thermoregulation and additional catecholamine liberation.
两名体温过低的患者（食管温度分别为27.2摄氏度和27.5摄氏度）被复温。第一例患者在饮酒后头部受伤，处于深度昏迷状态。在该患者中未观察到对寒冷的代谢或心血管调节反应。在复温过程中（27.2 - 37.2摄氏度），食管温度与全身耗氧量之间的关系通过Q10值2.75进行了量化。他的肾上腺素水平大幅升高至1000 pg/ml，而去甲肾上腺素水平仅适度升高至250 pg/ml。在插管期间或通过肺动脉导管未观察到室性早搏（PVCs）。第二例患者是一名87岁的意外低温患者。他在食管温度为27.5摄氏度时出现寒战，这表明存在持续的体温调节。与第一例患者不同，他的去甲肾上腺素水平升高至1500 pg/ml，而肾上腺素水平仅升至450 pg/ml。在体表复温开始后，观察到去甲肾上腺素水平进一步升高，并记录到PVCs的发生率增加（15次/分钟），当体温恢复正常时停止。我们的观察表明，深度低温复温期间的部分心脏并发症可能是由体温调节和额外的儿茶酚胺释放引起的。
