Pediatric Hypothermia: An Ambiguous Issue.

Publisher: MDPI Country of Publication: Switzerland NLM ID: 101238455 Publication Model: Electronic Cited Medium: Internet ISSN: 1660-4601 (Electronic) Linking ISSN: 16604601 NLM ISO Abbreviation: Int J Environ Res Public Health Subsets: MEDLINE

Original Publication: Basel : MDPI, c2004-

Hypothermia*/prevention & control ; Pediatrics*; Animals ; Body Temperature ; Body Temperature Regulation ; Child ; Humans ; Infant ; Infant, Newborn ; Infant, Premature

Hypothermia in pediatrics is mainly about small body size. The key thermal factor here is the large surface-to-volume ratio. Although small mammals, including human infants and children, are adapted to higher heat losses through their elevated metabolic rate and thermogenic capacity, they are still at risk of hypothermia because of a small regulatory range and an impending metabolic exhaustion. However, some small mammalian species (hibernators) use reduced metabolic rates and lowered body temperatures as adaptations to impaired energy supply. Similar to nature, hypothermia has contradictory effects in clinical pediatrics as well: In neonates, it is a serious risk factor affecting respiratory adaptation in term and developmental outcome in preterm infants. On the other hand, it is an important self-protective response to neonatal hypoxia and an evidence-based treatment option for asphyxiated babies. In children, hypothermia first enabled the surgical repair of congenital heart defects and promotes favorable outcome after ice water drowning. Yet, it is also a major threat in various prehospital and clinical settings and has no proven therapeutic benefit in pediatric critical care. All in all, pediatric hypothermia is an ambiguous issue whose harmful or beneficial effects strongly depend on the particular circumstances.

Am J Cardiol. 1983 Feb;51(3):557-61. (PMID: 6823870)
Surgery. 1953 Jan;33(1):52-9. (PMID: 13015312)
Pediatrics. 2016 Jan;137(1):. (PMID: 26702029)
Handb Clin Neurol. 2019;162:217-237. (PMID: 31324312)
Crit Care Med. 2015 Nov;43(11):e521-5. (PMID: 26317568)
Med J Aust. 1992 Nov 2;157(9):629-32. (PMID: 1406426)
FEBS J. 2019 Mar;286(6):1094-1100. (PMID: 30347515)
J Pediatr Surg. 2012 Dec;47(12):2239-43. (PMID: 23217883)
Resuscitation. 2021 Apr;161:327-387. (PMID: 33773830)
Respir Physiol. 1999 Aug 3;116(2-3):95-103. (PMID: 10487295)
Respir Physiol Neurobiol. 2004 Aug 12;141(3):215-28. (PMID: 15288595)
Crit Care Med. 2017 Apr;45(4):575-583. (PMID: 27941370)
J Cardiothorac Vasc Anesth. 2020 Feb;34(2):365-371. (PMID: 31932022)
Bratisl Lek Listy. 2018;119(5):294-297. (PMID: 29749244)
N Engl J Med. 2015 May 14;372(20):1898-908. (PMID: 25913022)
Physiology (Bethesda). 2019 Mar 1;34(2):101-111. (PMID: 30724130)
Pediatr Emerg Care. 2021 Jun 1;37(6):e284-e291. (PMID: 30106871)
BMJ. 2015 Feb 10;350:h418. (PMID: 25670715)
Int J Environ Res Public Health. 2021 Jul 15;18(14):. (PMID: 34299991)
JAMA. 1990 Oct 10;264(14):1856-7. (PMID: 2402046)
Resuscitation. 2010 Jun;81(6):645-52. (PMID: 20371145)
J Pediatr. 2012 Sep;161(3):422-6. (PMID: 22497906)
N Engl J Med. 2013 Dec 5;369(23):2197-206. (PMID: 24237006)
Acad Emerg Med. 2006 May;13(5):525-9. (PMID: 16569751)
Clin Perinatol. 2018 Jun;45(2):241-255. (PMID: 29747886)
Neonatology. 2015;107(3):220-3. (PMID: 25675993)
Anasthesiol Intensivmed Notfallmed Schmerzther. 2002 Aug;37(8):441-60. (PMID: 12165913)
Respir Physiol Neurobiol. 2005 Nov 15;149(1-3):243-55. (PMID: 15941675)
Curr Opin Crit Care. 2014 Apr;20(2):182-8. (PMID: 24553340)
Lancet Glob Health. 2021 Sep;9(9):e1273-e1285. (PMID: 34358491)
Pediatr Res. 2017 Jan;81(1-2):202-209. (PMID: 27673420)
Z Geburtshilfe Neonatol. 2013 Dec;217(6):220-4. (PMID: 24399321)
Comp Biochem Physiol A Mol Integr Physiol. 2021 Feb;252:110847. (PMID: 33212295)
Pediatr Emerg Care. 1997 Apr;13(2):98-102. (PMID: 9127416)
Anaesthesist. 2007 Sep;56(9):899-902, 904-6. (PMID: 17763837)
Biol Neonat. 1964;6:148-63. (PMID: 14136494)
Comp Biochem Physiol A Mol Integr Physiol. 1999 Jul;123(3):221-34. (PMID: 10501017)
Ann Surg. 1950 Nov;132(5):849-66. (PMID: 14771796)
N Engl J Med. 2017 Jan 26;376(4):318-329. (PMID: 28118559)
J Pediatr. 2018 Jan;192:53-59.e2. (PMID: 29246358)
Pediatr Res. 2006 Aug;60(2):174-9. (PMID: 16864699)
J Pediatr. 2016 Aug;175:61-67.e4. (PMID: 27189680)
Cochrane Database Syst Rev. 2016 Aug 23;(8):CD002771. (PMID: 27552521)
Crit Care Med. 1992 Oct;20(10):1402-5. (PMID: 1395660)
N Engl J Med. 2021 Jun 17;384(24):2283-2294. (PMID: 34133859)
Adv Exp Med Biol. 1972;33(0):571-86. (PMID: 4671938)
Pediatrics. 1964 Aug;34:171-81. (PMID: 14211077)
Curr Pediatr Rev. 2018;14(1):28-33. (PMID: 29651952)
J Matern Fetal Neonatal Med. 2022 Dec;35(25):4969-4975. (PMID: 33615985)
Pediatr Crit Care Med. 2016 Aug;17(8):712-20. (PMID: 27362855)
Perfusion. 2023 Jan;38(1):109-114. (PMID: 34472993)
Thorac Cardiovasc Surg. 1990 Aug;38(4):205-11. (PMID: 2237880)
Lancet Neurol. 2012 Jun;11(6):556-66. (PMID: 22608669)
Monogr Physiol Soc. 1983;40:1-168. (PMID: 6685226)
Scand J Trauma Resusc Emerg Med. 2016 Sep 15;24(1):111. (PMID: 27633781)
Nature. 2000 Feb 10;403(6770):597. (PMID: 10688176)
J Comp Physiol B. 1988;158(4):487-93. (PMID: 3220991)
Resuscitation. 2014 Sep;85(9):1204-11. (PMID: 24882104)
Prog Cardiovasc Dis. 1972 Nov-Dec;15(3):229-53. (PMID: 5086815)
N Engl J Med. 2021 May 27;384(21):2028-2038. (PMID: 34038632)
Lancet. 2002 Nov 2;360(9343):1394-5. (PMID: 12423988)
Children (Basel). 2018 Jul 19;5(7):. (PMID: 30029531)
Science. 2011 Feb 18;331(6019):906-9. (PMID: 21330544)
Eur J Cardiothorac Surg. 2020 Nov 1;58(5):1091-1092. (PMID: 33084865)
Arch Dis Child. 1969 Jun;44(235):323-30. (PMID: 5785182)
Lancet Neurol. 2013 Jun;12(6):546-53. (PMID: 23664370)
Ann Neurol. 2011 Nov;70(5):698-712. (PMID: 22162055)
J Appl Physiol (1985). 1999 Oct;87(4):1346-53. (PMID: 10517762)
JAMA Pediatr. 2015 Apr;169(4):e150277. (PMID: 25844990)
Indian J Pediatr. 2021 Jul 23;:. (PMID: 34297336)
J Pediatr. 1997 Feb;130(2):240-4. (PMID: 9042126)
Pediatr Neurol. 2018 Nov;88:12-24. (PMID: 30309737)
J Matern Fetal Neonatal Med. 2016;29(13):2049-55. (PMID: 27480206)
Emerg Med J. 2012 May;29(5):420-1. (PMID: 22045602)
Respir Physiol Neurobiol. 2004 Aug 12;141(3):345-56. (PMID: 15288604)
Acta Paediatr. 1995 Dec;84(12):1438-40. (PMID: 8645968)
Z Geburtshilfe Neonatol. 2000 May-Jun;204(3):85-92. (PMID: 10909163)
Respir Physiol Neurobiol. 2004 Aug 12;141(3):317-29. (PMID: 15288602)
Curr Neurol Neurosci Rep. 2019 Jan 14;19(2):2. (PMID: 30637551)
Pflugers Arch. 2019 Jun;471(6):819-828. (PMID: 30569200)
Pediatrics. 1958 Nov;22(5):876-86. (PMID: 13600915)
J Comp Physiol B. 1988;158(1):25-37. (PMID: 3385059)
Cochrane Database Syst Rev. 2018 Feb 12;2:CD004210. (PMID: 29431872)

Keywords: adaptation; body size; children; drowning; hibernation; hypothermia; hypoxia; infants; neonates; thermoregulation

Date Created: 20211113 Date Completed: 20211118 Latest Revision: 20240925

20240925

PMC8583576

10.3390/ijerph182111484

34769999