Hypothermia in children presents several challenges. It is common enough that clinicians will need to recognize and treat it, but uncommon enough that the details of care may be hard to recall. The diagnosis is surprisingly easy to overlook, and its treatment alters some standard practices. Although generally harmful, severe (and rapid) hypothermia may also provide cerebral protection against anoxia, allowing cases of remarkable survival after cardiac arrest [1-3].
The clinical manifestations of unintentional hypothermia in children will be reviewed here. Treatment of hypothermia in children, neonatal hypothermia, and frostbite are discussed separately. (See "Treatment of hypothermia in children" and "Short-term complications of the premature infant", section on 'Hypothermia' and "Frostbite".)
DEFINITION OF HYPOTHERMIA
Hypothermia is defined as a core body temperature below 35ºC (95ºF). The stage of hypothermia, defined by core temperature, has a large impact on both recognition and treatment. The most commonly used definitions found in the literature are as follows [4,5]:
- Mild - Core temperature 32 to 35ºC (90 to 95ºF)
- Moderate - Core temperature 28 to 32ºC (82 to 90ºF)
- Severe - Core temperature below 28ºC (82ºF)
In addition, some experts regard a core temperature <20ºC (68ºF) as profound hypothermia .