Anesthésie et recherche clinique
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Survival from Severe Accidental Hypothermia in an Elderly Woman: A Case Report

Mojgan Vazin, Viktoria Oline Lindberg-Larsen and Kenneth Jensen

Introduction: Accidental hypothermia is an environmental condition with basic principles of classification and resuscitation that is associated with significant morbidity and mortality despite aggressive treatment. Hypothermia is defined as a decrease in core body temperature (CBT) below 35°C and may be staged in mild (35°C-32°C), moderate (32°C-28°C) and deep (<24°C). The latter group is associated with significant risk of circulatory arrest. The considerations regarding acute illness and complicating hypothermia presents some challenges concerning stabilization and treatment. Case presentation: An 88 year-old woman with a previous medical history of dementia and first -degree atrioventricular block was found outside her home. As a result of exposure, the patient developed severe hypothermia with a core temperature of 19°C, hypoventilation, Glasgow Coma Scale 4, and sinus bradycardia. Critical care was initiated right away and included intubation, internal and external re-warming, and various drugs during orotracheal intubation. The next day she was extubated and discharged from the intensive care unit without any complications, and within four days she was discharged from the hospital. Conclusions: We describe some considerations regarding treatment and complications of severe hypothermia in an elderly patient, and a review of the physiological changes with exposure to hypothermia.