The Treatment of Hypothermia

The leading causes of accidental hypothermia in urban medical centers in the United States are exposure due to alcoholism, drug addiction, or mental illness and accidents involving immersion in cold water.1 Accidental hypothermia is classified as mild (body temperature, 32.2 to 35°C), moderate (temperature, 28 to <32.2°C), or severe (temperature, <28°C)2 and results in multiple systemic derangements that lead to decreased tissue oxygenation. These include depressed myocardial contractility, a shift in the oxyhemoglobin dissociation curve to the left, vasoconstriction, ventilation–perfusion mismatches, and increased blood viscosity. These disturbances lead to circulatory collapse, which results in lactic acidosis, hepatic and renal failure, . . .