Hypothermia with profound anemia and pancreatitis.
A patient with severe hypothermia presented with an initial rectal temperature of 28.3 degrees C coupled with a hemoglobin of 2.2 g x dL(-1) and acute pancreatitis. Although hypothermia decreases oxygen and substrate consumption by tissues and can be cerebro-protective, the ideal rewarming strategy is unclear when the oxygen-delivery system is profoundly deficient, as with severe anemia. In this patient, truncal active external rewarming with a forced-air system, heated inhalation, and slow warmed transfusion yielded a 1.5 degrees C x h(-1) rate of rewarming and a good outcome. We discuss the numerous protective and detrimental factors affecting oxygenation and ventilation during hypothermia coupled with profound anemia and the possible etiologic explanations for coexistent hypothermia and pancreatitis.
Department of Emergency Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA. collinsmed@yahoo.com
Aaron M
AM
Collins
Daniel F
DF
Danzl
D000740:Anemia / Q000150:complications*; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000628:therapy*; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D010195:Pancreatitis / Q000150:complications*; D017694:Rewarming / Q000379:methods*; D016896:Treatment Outcome
D010100:Oxygen