Tuesday, November 10, 2015

Hypothermia

Today in morning report we discussed the case of a patient who presented with hypothermia. We don't come across this every day in GIM so it is good to review the causes. Hypothermia is defined as a temperature less than 35 degrees Celsius. It is important to consider getting a second reading from a different body site to confirm that this is a true reading.

Environmental exposure is a common cause of hypothermia which can usually be elicited from the history. However, sometimes there is no history of cold exposure. In these cases you should think about the other causes of hypothermia. You can divide these into broad categories [that relate to the reasons your house might be too cold]:

Increased heat loss [the doors/windows are open]
  • Drugs that cause vasodilatation (drugs, alcohol)
  • Iatrogenic causes (cold infusions, CRRT, bypass)
  • Burns or severe skin conditions (psoriasis)

Reduced heat production [the furnace is not working properly]
  • Endocrine causes (hypothyroidism, adrenal insufficiency, hypopituitarism)
  • Hypoglycemia
  • Malnutrition
  • Reduced muscle activity (extreme elderly, inactivity)
Impaired regulation [the thermostat is incorrectly set]
  • Central CNS pathology (Stroke, intracranial hemorrhage, hypothalamic dysfunction, parkinsonism, MS, CNS drugs
  • Peripheral CNS pathology (spinal cord transection)

Miscellaneous causes [your house has an infection? ok, this one doesn’t apply to the house analogy]
  • Sepsis
  • Pancreatitis

Check out the following article for a nice review of hypothermia: http://www.aafp.org/afp/2004/1215/p2325.html  

2 comments :

Brown Ada said...

Good for self inspection and diagnosis. Are there any device can help the process? -BOC Sciences

Steven Rios said...

Waiting for more details about the "Increased heat loss" part.
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