We could say that this patient’s clinical course was changed by the first touch of the physician. After the first finding of hypothermia, mixedema coma was suspected andthe diagnosis was refined by clinical history and a simple laboratory test (revealing hyponatraemia), leading to the patient’s rescue. Indeed among the different conditions that can lead to hypothermia, few deserve special mention because failure to recognise atypical presentations and initiate early specific treatment sharply increases the rate of morbidity and mortality. Environmental hypothermia is obviously suspected in patients found outdoors in cold climates. With a rapidly growing interest in wilderness exploration, and outdoor and water sports, the incidence of hypothermia secondary to accidental exposure may indeed become more frequent in the general population. Sometimes ethanol can also cause hypothermia by increasing heat loss and vasodilation and by impairing behavioural response to cold. However, before starting passive external rewarming or minimally invasive active core rewarming with warmed IV fluids, other causes must be firstly suspected in elderly patients living indoors. The main causes of hypothermia in an elderly patient found indoors are linked to metabolic disorders leading to a decreased basal metabolic rate due to dysfunction of the thyroid, adrenal or pituitary glands.
Hypothermia with loss of consciousness and hyponatraemia / E. Incasa; M. Tampieri; A. Zangirolami; S. Gamberini; V. Di Chiara; B. Boari; S. Tartari; G. Benea; E. Righini; R. Manfredini; P. A. Modesti. - In: INTERNAL AND EMERGENCY MEDICINE. - ISSN 1828-0447. - ELETTRONICO. - 2:(2007), pp. 113-115. [10.1007/s11739-007-0031-0]
Hypothermia with loss of consciousness and hyponatraemia.
MODESTI, PIETRO AMEDEO
2007
Abstract
We could say that this patient’s clinical course was changed by the first touch of the physician. After the first finding of hypothermia, mixedema coma was suspected andthe diagnosis was refined by clinical history and a simple laboratory test (revealing hyponatraemia), leading to the patient’s rescue. Indeed among the different conditions that can lead to hypothermia, few deserve special mention because failure to recognise atypical presentations and initiate early specific treatment sharply increases the rate of morbidity and mortality. Environmental hypothermia is obviously suspected in patients found outdoors in cold climates. With a rapidly growing interest in wilderness exploration, and outdoor and water sports, the incidence of hypothermia secondary to accidental exposure may indeed become more frequent in the general population. Sometimes ethanol can also cause hypothermia by increasing heat loss and vasodilation and by impairing behavioural response to cold. However, before starting passive external rewarming or minimally invasive active core rewarming with warmed IV fluids, other causes must be firstly suspected in elderly patients living indoors. The main causes of hypothermia in an elderly patient found indoors are linked to metabolic disorders leading to a decreased basal metabolic rate due to dysfunction of the thyroid, adrenal or pituitary glands.File | Dimensione | Formato | |
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