Deep Accidental Hypothermia with Core Temperature Below 24°C Presenting with Vital Signs

Abstract

Abstract

Pasquier, Mathieu, Noemi Zurron, Barbara Weith, Pierre Turini, Fabrice Dami, Pierre-Nicolas Carron, and Peter Paal. Deep accidental hypothermia with core temperature below 24°C presenting with vital signs. High Alt Med Biol. 15:58–63, 2014.— Background: According to the Swiss hypothermia clinical staging, patients with stage III are unconscious with preserved vital signs, with core temperature usually between 24° and 28°C. With stage IV, vital signs are absent with core temperature <24°C.

Aims:

To describe a patient presenting with HT stage III with vital signs but a core temperature of <24°C, and to search for similar patients in the medical literature.

Materials and methods:

MEDLINE was used to search for cases of deep accidental hypothermia (<24°C) and preserved vital signs.

Results:

We found 22 cases in addition to our case (n=23). Median age was 44 years (IQR 36; range 4–83) and median core temperature 22°C (IQR 1.7; 17–23.8). Vital signs were often minimal. Seven patients developed ventricular fibrillation (VF). Twenty patients survived with excellent neurological outcome.

Conclusions:

Vital signs can be present in hypothermic patients with core temperature <24°C. In deeply hypothermic patients, a careful check and prolonged check of vital functions should be made, as vital signs may be minimal. The clinical Swiss staging remains valuable in the prehospital evaluation of hypothermic patients; its correlation with core temperature should be better defined.