Hypotermia in the elderly

  • Gianpaolo Bragagni UO Medicina Interna (Direttore: Dott. Gianpaolo Bragagni), Dipartimento Medico Azienda USL di Bologna, Ospedale di San Giovanni in Persiceto, Italy.
  • Anna Alberti UO Medicina Interna (Direttore: Dott. Gianpaolo Bragagni), Dipartimento Medico Azienda USL di Bologna, Ospedale di San Giovanni in Persiceto, Italy.
  • Giuliano Castelli UO Medicina Interna (Direttore: Dott. Gianpaolo Bragagni), Dipartimento Medico Azienda USL di Bologna, Ospedale di San Giovanni in Persiceto, Italy.
  • Federico Lari | larifede@yahoo.it UO Medicina Interna (Direttore: Dott. Gianpaolo Bragagni), Dipartimento Medico Azienda USL di Bologna, Ospedale di San Giovanni in Persiceto, Italy.

Abstract

Introduction

An 88-year-old woman suffered a cerebrovascular accident and was found on the floor of her cold house.

Materials and methods

At the time of admission to our division, the patient was unresponsive with a rectal temperature of 28 °C, blood pressure of 120/80 mmHg, and a heart rate of 40 bpm. The cerebral CT revealed a hypodense lesion in the temporal region. The ECG showed sinus bradycardia, prolonged PR and QTc intervals, and a classic “J” (Osborn) wave that was most pronounced in the lateral and inferior leads. The patient presented a low respiratory rate, hypoventilation, severe acidosis (both respiratory and metabolic), hyperkalemia, elevated liver enzymes, mild anemia, hyporeflexia, and sluggish pupil responses.

Results

During rewarming with thermic blanket and heated intravenous fluids, the respiratory condition improved, and the ECG alterations disappeared. Twenty-four hours later, however, the patient died suddenly due to cardiac asystole.

Discussion

This report analyses the effects of hypothermia and its clinical manifestations and provides a brief discussion of the electrophysiologic mechanisms underlying Osborn waves and the other electrocardiographic changes associated with hypothermia.

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Published
2012-01-30
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Section
Case Reports
Keywords:
Hypothermia, ECG, Elderly
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How to Cite
Bragagni, G., Alberti, A., Castelli, G., & Lari, F. (2012). Hypotermia in the elderly. Italian Journal of Medicine, 6(1), 47-51. https://doi.org/10.4081/itjm.2012.47