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Woehrle, T.; Lichtenauer, U.; Bayer, A.; Brunner, S.; Angstwurm, M.; Schaefer, S. T.; Baschnegger, H. (2018): Misleading symptoms and successful noninvasive rewarming of apatient with severe hypothermia (23.1 degrees C). In: Anaesthesist, Vol. 67, No. 12: pp. 931-935
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Accidental severe hypothermia is amedical emergency in which symptoms may include coma, apnea, pulmonary edema, ventricular dysrhythmia or asystole. Despite optimal treatment, mortality remains high. This article reports acase of severe hypothermia in ageriatric hypothyroid patient, where despite abody core temperature of 23.1 degrees C the patient presented conscious and with stable vital signs, pronounced motor response, and aGlasgow Coma Scale score of9. Blood gas analysis (alpha stat at 37 degrees C) indicated sufficient pulmonary function. Anoninvasive rewarming approach proved successful and resulted in discharge without sequelae. This case highlights that symptoms considered pathognomonic for specific stages of hypothermia should be interpreted with great care in clinical practice. Hypothyroidism may have contributed to this uncommon clinical presentation. Body temperature needs to be taken into account when interpreting blood gas analyses. Even at the stage of severe hypothermia, noninvasive forced-air warming enabled rewarming without complications.