Temperature regulation is markedly impaired after brainstem death because of a reduction in heat production secondary to the fall in metabolic rate, loss of muscular activity, and peripheral vasodilation. Although mild hypothermia may protect vital organs, temperatures below 32 °C can result in decreased cardiac performance and coagulopathy. Moreover, brainstem death cannot be diagnosed in a hypothermic patient (core temperature below 35 °C). Core temperature should be maintained above 35 °C by increased insulation and active warming of the patient.

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