International journal of circumpolar health
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Accidental hypothermia is known to be a hazard to elderly people in temperate and cold climate. This is a review of the literature focusing on risk factors, clinical presentation and treatment of hypothermia in the elderly. ⋯ Clinical treatment protocols seems to be based on experience from younger patients. Based on general knowledge in geriatric medicine and experience from three recent cases of hypothermia in the elderly, the use of careful, active external rewarming and a low stress strategy are recommended for elderly patients.
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Int J Circumpolar Health · Oct 2000
ReviewRewarming from hypothermia. Newer aspects on the pathophysiology of rewarming shock.
The fatal circulatory derangements often observed when resuscitating victims of accidental hypothermia by rewarming are recognized as a falling cardiac output and a sudden drop in blood pressure, termed "rewarming shock". The real cause of this rewarming shock, or rewarming collapse, is, so far, unknown. ⋯ Cellular calcium overload, disturbed calcium homeostasis, changes in myocardial myofilament responsiveness to intracellular calcium as well as impaired high energy phosphate homeostasis could all be proposed as important factors leading to the changes observed in the hypothermic heart. Together with alteration of capillary function, increased capillary leakage of plasma protein, changes in intra- and extravascular volume-homeostasis and alteration of autonomous vascular control they all contribute to a maintained low cardiac output during and after rewarming which is associated with a fatal outcome.