title: Accidental hypothermia in severe trauma.
abstract: Hypothermia, along with acidosis and coagulopathy, is part of the lethal triad that worsen the prognosis of severe trauma patients. While accidental hypothermia is easy to identify by a simple measurement, it is no less pernicious if it is not detected or treated in the initial phase of patient care. It is a multifactorial process and is a factor of mortality in severe trauma cases. The consequences of hypothermia are many: it modifies myocardial contractions and may induce arrhythmias; it contributes to trauma-induced coagulopathy; from an immunological point of view, it diminishes inflammatory response and increases the chance of pneumonia in the patient; it inhibits the elimination of anaesthetic drugs and can complicate the calculation of dosing requirements; and it leads to an over-estimation of coagulation factor activities. This review will detail the pathophysiological consequences of hypothermia, as well as the most recent principle recommendations in dealing with it.
authors.affiliation: Équipe d'accueil « Modélisation de l'agression tissulaire et nociceptive », Toulouse University Teaching Hospital, Université Toulouse III Paul-Sabatier, Hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, 31059 Toulouse cedex 09, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Vardon
authors.affiliation: Équipe d'accueil « Modélisation de l'agression tissulaire et nociceptive », Toulouse University Teaching Hospital, Université Toulouse III Paul-Sabatier, Hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, 31059 Toulouse cedex 09, France.
authors.forename: Ségolène
authors.initials: S
authors.lastname: Mrozek
authors.affiliation: Équipe d'accueil « Modélisation de l'agression tissulaire et nociceptive », Toulouse University Teaching Hospital, Université Toulouse III Paul-Sabatier, Hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, 31059 Toulouse cedex 09, France. Electronic address: geeraerts.t@chu-toulouse.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Geeraerts
authors.affiliation: Équipe d'accueil « Modélisation de l'agression tissulaire et nociceptive », Toulouse University Teaching Hospital, Université Toulouse III Paul-Sabatier, Hôpital Pierre-Paul-Riquet, CHU de Toulouse, place du Dr-Baylac, 31059 Toulouse cedex 09, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Fourcade
mesh_terms: D000138:Acidosis / Q000209:etiology / Q000401:mortality; D001778:Blood Coagulation Disorders / Q000209:etiology / Q000401:mortality; D006801:Humans; D007035:Hypothermia / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D014947:Wounds and Injuries / Q000150:complications* / Q000401:mortality
keywords: Coagulopathy; Haemostasis; Hypothermia; Mortality; Polytrauma