[Rewarming from moderate to deep hypothermia: plasma catecholamine content, metabolism and circulatory function. 2 case reports].
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.
D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D001831:Body Temperature; D001833:Body Temperature Regulation; D002395:Catecholamines / Q000097:blood*; D005112:Extracorporeal Circulation; D006439:Hemodynamics; D006801:Humans; D007035:Hypothermia / Q000503:physiopathology*; D008297:Male; D013997:Time Factors
D002395:Catecholamines
Wiedererwärmung bei mittlerer bis tiefer Hypothermie: Plasma-Katecholamin-Verhalten, Metabolismus und Kreislauffunktion. 2 Fallberichte.