Hypothermie accidentelle chez le traumatisé grave

Hypothermia is, with acidosis and coagulopathy, a part of the lethal triad and is well known to worsen outcome in severe traumatized patients. If accidental hypothermia is easy to recognize by a simple measure, it remains deleterious if not prevented or treated from the initial phase of the trauma patient care. Hypothermia is multifactorial and constitutes a predictive factor of mortality in multiple trauma. Consequences of hypothermia are multiple: it modifies myocardial contractility and favors arrhythmias. It is a leading part of the traumatic coagulopathy. From the immunological point of view, it decreases the inflammatory reaction and increases pneumonia rate. Hypothermia decreases anesthetics and sedatives clearance and disturbs the performance of biological dosages, particularly leads to an overestimation of coagulation factors activity. This review aims at describing the pathophysiological consequences of hypothermia and to remind the recently published recommendations on this topic.