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.

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Sleep Apnea

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