Raising the body temperature must be progressive at a speed inversely proportional to the degree of hypothermia, particularly when the temperature is below 30 °C. The patient should be maintained at room temperature (20-22 °C) and covered with blankets. This external warming allows gradual vascular expansion in a patient with hypovolemia and peripheral vasoconstriction ( Nicoloffand LoPresti 1993).

If aggressive external or internal warming is used, peripheral vasodilatation occurs too rapidly and precipitates cardiovascular collapse. Respiratory assistance

Upper airways must be kept free to ensure proper ventilation. When the patient's condition is worrying (e.g. severe hypoxia or hypercapnia), respiratory assistance should be implemented without delay by endotracheal intubation and mechanical ventilation in that order ( NIcoIo.Ë,..a.n.d LoPresti 1993).

Tissue hypoxia is often aggravated because of anemia. Ventilatory function can be made worse by a pulmonary infection which acts as a frequent precipitating event.

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