Accidental Hypothermia Is Associated With Increased Mortality After Traumatic Brain Injury
Accidental hypothermia affects as many as two in three people who present to the emergency department for major trauma. Defined as a body temperature below 95ºF, hypothermia may occur after trauma for many reasons, including environmental exposure, shock, or anesthetics. Physicians know that major trauma patients who suffer from accidental hypothermia tend to have worse health outcomes, such as higher mortality rate and longer length of hospital stay. However, few studies have examined the effects of accidental hypothermia after traumatic brain injury (TBI) specifically.
A recent study addressed this knowledge gap by comparing outcomes among general trauma patients and TBI patients who suffered from accidental hypothermia after injury. The research team conducted an analysis of relevant literature on this topic, using data from 14 high-quality studies to draw conclusions about the effects of accidental hypothermia. They determined that, much like general trauma patients with hypothermia, TBI patients with accidental hypothermia also have worse outcomes and significantly higher mortality rate than those who present to the hospital with a normal body temperature. The researchers also found that hypothermic TBI patients are more likely to need a blood transfusion, elevating their risk of complications and increasing health care costs.
Although intentional, managed hypothermia is a cutting-edge treatment for TBI patients, accidental hypothermia is dangerous and should be avoided at all costs. To reduce the risk of accidental hypothermia after trauma, emergency responders and physicians should be prepared to:
- Remove wet clothing
- Warm the patient's room, blankets, and transfused blood (if necessary) prior to arrival
- Avoid unnecessarily anesthetizing the patient
- Perform thoracic lavage, an internal warming technique in which heated fluid is run through a series of chest tubes
- Avoid prolonged open surgery, when possible
TBI is a serious condition that requires careful, complex management. Treatment for accidental hypothermia should be standard protocol for the high proportion of trauma patients who present to the emergency department with low body temperature.
Rösli D, Schnürige B, Candinas D, & Haltmeier T. The impact of accidental hypothermia on mortality in patients overall and patients with traumatic brain injury specifically: A systematic review and meta-analysis. World Journal of Surgery. (August 2020).