Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- exposição ao frio e temperatura corporal <35 °C (<95 °F)
- comprometimento do estado mental
- tremores
- congelamento das extremidades
Outros fatores diagnósticos
- taquipneia, taquicardia, hipertensão
- depressão respiratória, bradicardia, hipotensão
- coma e apneia
- diurese induzida pelo frio
Fatores de risco
- trauma
- afogamento
- uso de anestesia geral
- uso indevido de substâncias
- cognição comprometida
- hipotireoidismo
- acidente vascular cerebral (AVC)
- Doença de Parkinson
- desabrigo
- extremidades etárias
- septicemia Gram-negativa
- imobilidade
- uso de determinados medicamentos
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- medição da temperatura central
- eletrocardiograma (ECG) de 12 derivações
- Hemograma completo
- eletrólitos séricos
- glicemia
- gasometria arterial
- exames de coagulação
- radiografia torácica
Investigações a serem consideradas
- creatinoquinase sérica
- níveis de mioglobina
- CO₂ ao final da expiração
- ultrassonografia
Algoritmo de tratamento
hipotermia leve: >32 °C a 35 °C (>90 °F a 95 °F)
hipotermia moderada ou grave, sem parada cardíaca: ≤32 °C (≤90 °F)
hipotermia moderada ou grave em parada cardíaca: ≤32 °C (≤90 °F)
Colaboradores
Autores
Emmanuel Atta Agaba, MD, FRCSEd, FACS
Attending Surgeon
Assistant Professor of Surgery
Montefiore Medical Center at Albert Einstein College of Medicine
Bronx
NY
Declarações
EAA declares that he has no competing interests.
Agradecimentos
Dr Emmanuel Agaba would like to gratefully acknowledge Dr Rafael Barrera and Dr Juan Jose Gilbert, previous contributors to this topic.
Declarações
RB and JJG declare that they have no competing interests.
Revisores
Wail Malaty, MD
Clinical Professor
Department of Family Medicine
University of North Carolina
Chapel Hill
Assistant Program Director
MAHEC Rural Family Medicine Residency
Hendersonville
NC
Disclosures
WM declares that he has no competing interests.
James S. Milledge, MBBS
Honorary Professor
Department of Physiology
University College London
London
UK
Disclosures
JSM declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Paal P, Pasquier M, Darocha T, et al. Accidental hypothermia: 2021 update. Int J Environ Res Public Health. 2022;19(1):501.Full text Abstract
Lott C, Truhlář A, Alfonzo A, et al. European Resuscitation Council guidelines 2021: cardiac arrest in special circumstances. Resuscitation. 2021 Apr;161:152-219.Full text Abstract
Panchal AR, Bartos JA, Cabañas JG, et al. Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020 Oct 20;142(16 Suppl 2):S366-468.Full text Abstract
Dow J, Giesbrecht GG, Danzl DF, et al. Wilderness Medical Society clinical practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia: 2019 update. Wilderness Environ Med. 2019 Dec;30(4 Suppl):S47-69.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Sepse
- Hipotireoidismo
- Hipoglicemia
More DifferentialsGuidelines
- European Resuscitation Council guidelines 2021: cardiac arrest in special circumstances
- European Resuscitation Council guidelines 2021
More GuidelinesCalculators
Escore Hypothermia outcome prediction after ECLS (HOPE; predição da desfechos da hipotermia após ECLS)
More Calculators
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