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<< Evidence-Based Management Of Accidental Hypothermia In The Emergency Department

Controversies

Core Afterdrop

There is much discussion surrounding the phenomenon of core afterdrop, which is the decrease in core temperature secondary to increasing blood flow to cold extremities. This causes the return of cold, acidemic blood to central circulation, in turn causing further drop in core temperature and worsening acidosis. Peripheral vasodilation also contributes to hemodynamic instability, and all of these factors put the patient at increased risk of fatal dysrhythmias during the rewarming process. Patients with moderate-to-severe hypothermia are particularly sensitive to even a small temperature drop, and this can lead to circulatory collapse.

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