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Hypothermia

 
 
Hypothermia is a medical emergency that occurs when the body loses heat faster than it can produce heat, causing a dangerously low body temperature.
Normal body temperature is around (37 C).
 Hypothermia occurs as body temperature passes below (35 C).
 
Causes of Hypothermia
 
Congestive heart failure
Drugs and intoxicants
  • Alcohol
  • Anesthetics, general
  • Antidepressants
  • Antithyroid agents
  • Barbiturates
  • Benzodiazepines
  • Cancer chemotherapy
  • Clonidine
  • Hypnotics/sedatives
  • Lithium
  • Marijuana
  • Neuromuscular blockers
  • Opiates
  • Phenothiazines
  • Tranquilizers
Endocrine disorders
  • Adrenal insufficiency
  • Diabetic ketoacidosis
  • Hypoglycemia
  • Hypopituitarism
  • Hypothyroidism

Environmental exposure (especially in neonates; premature or low birth weight babies; the elderly; or persons who are mentally impaired, unconscious, immobilized, drugged, debilitated, under anesthesia, wearing inadequate clothing, or exhausted)
  • Accidental
    • Cold water immersion
    • Sports related
    • Occupational
    • Wet clothing
  • Iatrogenic
    • Administration of cold blood or intravenous fluids
    • Iced saline gastric lavage
    • Peritoneal dialysis
Hepatic failure
Increased cutaneous blood flow
  • Burns
  • Erythrodermas (including toxic epidermal necrolysis and psoriasis)
Malnutrition
Myocardial infarction
Neurologic disorders
  • Central [hypothalamic and central nervous system (CNS) dysfunction; note: the hypothermia may be paroxysmal]
    • Anorexia nervosa
    • Brain tumors
    • Cerebrovascular accidents, paralysis, paresis
    • Encephalopathy
    • Episodic spontaneous hypothermia with hyperhidrosis (including those with agenesis of the corpus callosum—Shapiro syndrome)
    • Head trauma
    • Other hypothalamic lesions (e.g., infarction, midbrain lesions, sarcoidosis)
    • Parkinson disease
    • Prolonged cardiopulmonary resuscitation
    • Seizure
    • Spontaneous periodic hypothermia (paroxysmal hypothermia—nearly always with evidence

of injury to the preoptic area of the hypothalamus)
    • Wernicke encephalopathy
  • Peripheral
    • Diabetic autonomic neuropathy
    • Spinal cord transection above T1
Pancreatitis
Prolonged surgery
Respiratory failure
Sepsis
Shock
Uremia
 
 
References
1. Danzl DF. Hypothermia and frostbite, p. 122. See Bibliography, 1.
2. Yoder E. Disorders due to heat and cold, p. 628. See Bibliography, 5.
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