[Hypothermia in traumatology].
Basing on the experience of the Chamonix hospital team which managed in six years 89 cases of hypothermia in trauma patients, this article reviewed the literature concerning the association hypothermia-trauma. Shock is a major triggering factor. The deleterious effects of hypothermia on the outcome is due to inadequate cardiorespiratory adaptation to shock and to increased bleeding. Although a few articles reported a beneficial effect of hypothermia in head trauma, further studies are required to assess the value of deliberate hypothermia in such patients. Restoration of a satisfactory haemodynamic activity is a priority and most often requires surgery. The rewarming manoeuvres should be initiated early and always be preventive. They are active, internal and rapid in case of haemodynamic instability and when the central temperature is below 32 degrees C. It can be more progressive and less invasive in other cases. During recovery from anaesthesia the patient must be closely monitored. In spite of a possible protecting effect, hypothermia remains an aggravating factor in traumatology and must therefore be either prevented or amended.
Rousseau
J M
JM
Service d'anaesthésie-réanimation, hôpital d'instruction des armées du Val-de-Grâce, Paris, France.
Marsigny
B
B
Cauchy
E
E
Bonsignour
J P
JP
D000059:Accidents / Q000706:statistics & numerical data; D000328:Adult; D000758:Anesthesia / Q000379:methods; D000818:Animals; D001831:Body Temperature; D004632:Emergency Medical Services / Q000379:methods*; D005392:First Aid / Q000379:methods; D005602:France / Q000453:epidemiology; D006706:Homeostasis; D006801:Humans; D007035:Hypothermia / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D002534:Hypoxia, Brain / Q000209:etiology; D008875:Middle Aged; D009051:Mountaineering; D012121:Respiration, Artificial; D017694:Rewarming / Q000009:adverse effects / Q000379:methods; D012720:Severity of Illness Index; D012769:Shock / Q000209:etiology / Q000628:therapy; D014666:Vasomotor System / Q000503:physiopathology; D014947:Wounds and Injuries / Q000150:complications / Q000453:epidemiology