Electrolytes and acidbase findings

Sodium, chloride, calcium, magnesium, and phosphate concentrations may be normal, high, or low. Owing to a shift of potassium into cells, hypokalemia is seen during hypothermia.

An initial respiratory alkalosis is followed by respiratory or mixed acidosis. Hypothermia modifies blood gas analysis values and shifts the oxyhemoglobin curve. Blood pH values are higher and PaO2 and PaCO2 values are lower than those determined at 37 °C. Since no normal physiological values have been established for hypothermia, it is more convenient for clinical use to perform blood gas analysis at 37 °C without correction for temperature.

Low temperature shifts the oxyhemoglobin curve to the left, decreasing peripheral oxygen delivery. Simultaneously, concomitant acidosis may shift the curve to the right, confusing the picture. Oxygen delivery may be further impaired by increased blood viscosity, low cardiac output, and respiratory failure.

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