Infection-key in treating hypothermia?

Abstract

Aim of the study: Hypothermia as the major clinical feature at emergency admission poses a low-frequency yet complex and life-threatening challenge. Limited knowledge about its morbidity, mortality, and influencing factors contributes to the absence of standardized guidelines for rewarming treatments. This retrospective study, the first of its kind in Portugal, aims to fill this gap by examining hypothermic patients in a temperate climate, exploring rewarming treatments, mortality factors, and complications.

Methods: Conducted at the Emergency Department of Centro Hospitalar Vila Nova de Gaia/Espinho, the study spanned from January 2008 to December 2020. Sixty-two patients with body temperatures below 35ºC were included. Data collection focused on patient background, clinical presentation, hypothermia mechanism, reperfusion treatment, and laboratory results. Clinical infection was defined based on symptoms and imaging findings.

Results: The study revealed a diverse cohort, with an average age of 82 and a mortality rate of 33.9%. Clinical infection was prevalent in 51.6% of patients, mostly respiratory (59.4%). Rewarming treatments varied, and no specific method showed significant advantage. Complications included rhabdomyolysis, and late deaths were primarily attributed to infectious diseases, particularly pneumonia.

Conclusions: Taking into account its high mortality rate, accidental hypothermia, demands further research and multicenter data collection for evidence-based treatment strategies. Clinical infection emerged as a significant factor in mortality, prompting a call for increased attention to infectious disease identification and treatment during hypothermic episodes.