RT Book, Section A1 Hanania, Nicola A. A1 Zimmerman, Janice L. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Wood, Lawrence D.H. SR Print(0) ID 2282615 T1 Chapter 110. Hypothermia T2 Principles of Critical Care, 3e YR 2005 FD 2005 PB The McGraw-Hill Companies PP New York, NY SN 9780071416405 LK accessmedicine.mhmedical.com/content.aspx?aid=2282615 RD 2022/08/12 AB Accidental hypothermia results from the unintentional decrease in core body temperature to lower than 35°C (95°F) and can be classified as mild (32.2°C to 35°C, or 90°F to 95°F), moderate (28°C to 32.2°C, 82°F to 90°F), or severe (<28°C, 82°F).Although hypothermia from environmental exposure is very common, several medical conditions may also predispose to hypothermia necessitating hospitalization and admission to the intensive care unit.Individuals at highest risk for hypothermia include the homeless, the mentally ill, trauma victims, outdoor workers, those at the extremes of age, those with serious underlying medical conditions, and those with ethanol or drug intoxication.Several organ systems are affected by hypothermia: clinical manifestations depend on the underlying cause and core body temperature. Below 30°C (86°F), shivering ceases, level of consciousness progressively declines, and cardiac arrhythmias become more common.In the initial stages, wet clothing should be removed promptly, continued heat loss must be prevented, and the underlying illness should be identified and treated.Rewarming is the primary treatment for moderate to severe hypothermia. For patients with a core body temperature above 32°C (90°F), passive and active external rewarming and supportive therapies are preferred; for patients with lower temperatures and those with hemodynamic instability, active core rewarming using body cavity lavage or extracorporeal blood warming may be considered.In addition to rewarming, all patients with hypothermia need continuous monitoring of cardiac status, intensive fluid resuscitation, and circulatory support.