Johnson L A
JACEP. 1977 Dec;6(12):556-61. doi: 10.1016/s0361-1124(77)80428-0.
Accidental hypothermia may develop within a few minutes by immersion in cold water, in a matter of hours by exposure to cold weather, and in a matter of days in debilitatted victims by continuous exposure to milder cold stress. The prognosis in accidental hypothermia depends on the patient's premorbid condition, the depth and duration of the hypothermia and the degree of exhaustion and metabolic acidosis that result from physiologic attempts to compensate for the heat loss. For deep hypothermia (deep body temperature below 20 C [82.4F]), internal rewarming is strongly recommended as a means of supporting function in body core organs and minimizing the risk of "rewarming shock". For lesser degrees of hypothermia, recoverability depends more on the adequacy of supportive care than on the method of rewarming. The rapid and complete recovery experienced in the case presented is not surprising since the patient's premorbid condition was good, chilling had been rapid, metabolic exhaustion was mild, and internal rewarming was accomplished without delay, using heated peritoneal dialysis.
意外低温可能在几分钟内因浸入冷水中而发生，在几小时内因暴露于寒冷天气而发生，而在身体虚弱的受害者中，因持续暴露于较温和的冷应激下，可能在数天内发生。意外低温的预后取决于患者病前状况、低温的深度和持续时间，以及因生理上试图补偿热量损失而导致的衰竭程度和代谢性酸中毒。对于深度低温（深部体温低于20℃[82.4℉]），强烈建议进行体内复温，以支持身体核心器官的功能，并将“复温休克”的风险降至最低。对于较轻程度的低温，恢复能力更多地取决于支持性护理的充分性，而非复温方法。所呈现病例中患者迅速且完全康复并不奇怪，因为患者病前状况良好，发冷迅速，代谢衰竭轻微，且使用加热腹膜透析及时完成了体内复温。
