Hypothermia is defined as a core body temperature ≤35° Celsius, and is common in critically ill trauma patients. Accidental hypothermia on the emergency department (ED) is frequently observed in trauma patients and is associated with poor outcomes. However, the impact of hypothermia present upon ICU admission on mortality is not known while the occurrence of “indoor” hypothermia was found to be linked to worse outcome than “outdoor” hypothermia according to a study in a medical ICU population[1].
This multicenter retrospective cohort study here was, therefore, conducted to evaluate the impact of hypothermia upon admission to the Intensive Care Unit (ICU) on early and late mortality in severely injured trauma patients. 953 adult patients that were included in the study were admitted to the ED and subsequently transferred to the ICU of two Level 1-trauma centers in Amsterdam, the Netherlands. These patients were divided into two groups: hypothermic and non-hypothermic groups.
Of a total of 953 patients admitted to the ICU, 354 (37%) patients had hypothermia. The hypothermic group was more severely injured, coagulopathic, acidotic, and had higher mortality rates. Of the patients with hypothermia, 29 (8%) patients died within 24 h and 101 patients (57%) within 28 days. Almost 50% of the patients who died within 28 days had a core body temperature lower than 32°C on admission to the ICU. The mortality rate in normothermic patients was significantly lower, 11 patients (2%) with 24 h and 57 patients within 28 days (10%).
This study shows that upon ICU admission following trauma, hypothermia is one of the most important physiological predictors for both early and late mortality in trauma patients. Hypothermia may aggravate bleeding, therefore, aggressive prevention or correction of the body temperature by rewarming techniques – e.g., warm fluid resuscitation – could influence the incidence of hypothermia on ICU admission and subsequently mortality.
Read the entire article here. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4960783/
[1] Mégarbane B, Axler O, Chary I, Pompier R, Brivet FG. Hypothermia with indoor occurrence is associated with a worse outcome. Intensive Care Med. 2000;26:18439. [PubMed] [Google Scholar]
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