Hypothermia: Pathophysiology and the propensity for infection.

Autor: Werner LM; Walter Reed Army Institute of Research, 503 Robert Grant Ave. Silver Spring, MD, 20910, USA. Electronic address: lacie.m.werner.ctr@health.mil., Kevorkian RT; Walter Reed Army Institute of Research, 503 Robert Grant Ave. Silver Spring, MD, 20910, USA., Getnet D; Walter Reed Army Institute of Research, 503 Robert Grant Ave. Silver Spring, MD, 20910, USA., Rios KE; Walter Reed Army Institute of Research, 503 Robert Grant Ave. Silver Spring, MD, 20910, USA., Hull DM; Walter Reed Army Institute of Research, 503 Robert Grant Ave. Silver Spring, MD, 20910, USA., Robben PM; Walter Reed Army Institute of Research, 503 Robert Grant Ave. Silver Spring, MD, 20910, USA., Cybulski RJ; Walter Reed Army Institute of Research, 503 Robert Grant Ave. Silver Spring, MD, 20910, USA., Bobrov AG; Walter Reed Army Institute of Research, 503 Robert Grant Ave. Silver Spring, MD, 20910, USA. Electronic address: alexander.g.bobrov.civ@health.mil.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2024 Nov 20; Vol. 88, pp. 64-78. Date of Electronic Publication: 2024 Nov 20.
DOI: 10.1016/j.ajem.2024.11.029
Abstrakt: Hypothermia in combination with infection presents a complex challenge in clinical and battlefield medicine. Multifaceted physiological and immunological consequences of hypothermia drastically change the risk, progression, and treatment of a concomitant infection. Managing hypothermia and infection in extreme cold settings is particularly relevant in an era with increased risk of military operations in Polar climates. Here, we discuss the elevated instance of infection during accidental and therapeutic hypothermia and speculate how a compromised immune system may contribute. We focus on skin and soft tissue infections and sepsis, which are among the serious infectious complications of hypothermia and battlefield injuries. We also present the challenges associated with treating infections under hypothermic conditions. Finally, we advocate for a renewed focus on identifying causal relationships between hypothermia and infection risk and assessing established infection treatment regiments in hypothermic patients to enhance trauma management and survival outcomes in hypothermia-related injuries.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: CPT Richard Kevorkian reports financial support was provided by US Department of Defense JPC-6 Combat Casualty Care Research Program. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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