Prognosis

Poor prognostic factors include advanced age, comorbid states, the circumstances and severity of hypothermia, and cardiorespiratory arrest. A patient who has been trapped under a snow avalanche with other injuries may have a worse outcome than a drug-intoxicated patient with hypothermia. Hypothermia associated with septic shock carries a high mortality.

The severity of hypothermia, the duration of exposure to cold, cardiac arrest, or a silent electroencephalogram cannot be used to predict the chance of survival in a clinically dead hypothermic patient. Such patients have been successfully rewarmed and resuscitated without any neurological sequelae after hours of cardiorespiratory arrest. The lowest recorded temperature in a survivor of accidental hypothermia is 14.2 °C. Thus clinically moribund hypothermic patients should be rewarmed before being declared dead. Extreme hyperkalemia (12-14 mmol/l) in hypothermic patients with cardiorespiratory arrest and non-reactive pupils is ominous and may imply that death has probably occurred. Hypothermia produces hypokalemia, unless it is associated with rhabdomyolysis secondary to trauma or acute heroin overdose.

Sleep Apnea

Sleep Apnea

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