Frank D H, Robson M C
Surg Gynecol Obstet. 1980 Sep;151(3):379-81.
Accidental hypothermia, a core temperature below 34 degrees C., is frequently fatal, particularly in the ill and elderly. Traditional treatment methods result in reported mortalities of between 45 and 100 per cent. Despite these terrible statistics, advocates of slow rewarming persist. They cite the shock and vascular collapse which can occur with peripheral dilation as reasons to avoid rapid external rewarming. Isolated successes using internal core rewarming, such as hemodialysis or cardiopulmonary bypass, are spectacular but not practical in the usual clinical situation. By combining methods used for the resuscitation of burn injury with the treatment principles for frostbite, a highly effective treatment protocol results. Agressive fluid resuscitation, rapid immersion rewarming and careful systematic monitoring have been used to treat ten consecutive patients without a single death. Concomitant problems of alcoholism, stroke, myxedema, tuberculosis and paraplegia were also treated. Rapid external rewarming by immersion can result in a low mortality in patients with severe hypothermia.
意外低温，即核心体温低于34摄氏度，通常是致命的，尤其在病人和老年人中。传统治疗方法的报告死亡率在45%至100%之间。尽管有这些可怕的数据，但仍有提倡缓慢复温的人。他们将外周血管扩张可能导致的休克和血管塌陷作为避免快速体表复温的理由。使用诸如血液透析或体外循环等体内核心复温方法取得的个别成功案例令人瞩目，但在通常的临床情况下并不实用。通过将烧伤复苏方法与冻伤治疗原则相结合，形成了一种高效的治疗方案。积极的液体复苏、快速浸泡复温和仔细的系统监测已被用于连续治疗10例患者，无一例死亡。同时还对酗酒、中风、黏液性水肿、肺结核和截瘫等伴随问题进行了治疗。通过浸泡进行快速体表复温可使严重低温患者的死亡率降低。
