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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During 1969-77, 20 episodes of severe hypothermia occurred in 19 diabetic patients in Nottingham. Thirteen were associated with ketotic hyperosmolar coma, two with lactic acidosis, and one with hypoglycaemia, while in four there was no loss of diabetic control. Ketoacidosis accounted for 11.8% of all admissions for severe accidental hypothermia and was a commoner cause than hypothyroidism (8%). Patients with ketoacidosis were younger and developed hypothermia as often during the summer as during the winter. The metabolic disturbance was characteristic, with severe acidosis (mean pH 7.04), a high blood glucose concentration (mean 56.6 mmol/l; 1020 mg/100 ml), and high plasma osmolality (mean 379.7 mmol (mosmol)/kg). Eight of the 13 episodes proved fatal. Hypothermia may aggravate ketoacidosis and complicate treatment and should be sought in all patients with severe diabetic coma.
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PMID:Hypothermia: a complication of diabetic ketoacidosis. 10 2

Diabetic ketoacidosis with hypothermia is underrecognized, and the mortality rate is high at between 30% and 60%. The cause of hypothermia in diabetic ketoacidosis patients is speculative and has multiple factors. Insulin deficit is the most important factor that leads to a lack of substrate for cellular heat production. Water depletion and low environment temperature may also be contributing factors, especially in patients with a severe diabetic coma. Hypothermia may also aggravate uncontrolled diabetes mellitus and complicate treatment because insulin secretion is impaired and exogenous administered insulin is less effective at low temperatures. We present a case, the first in the literature, of severe diabetic ketoacidosis with marked hypothermia and cardiovascular instability that was successfully resuscitated by venoarterial extracorporeal membrane oxygenation support. Based on this report, we suggest that portable venoarterial extracorporeal membrane oxygenation should be considered to treat patients with severe diabetic ketoacidosis and hypothermic cardiocirculatory instability.
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PMID:Venoarterial extracorporeal membrane oxygenation resuscitation in diabetic ketoacidosis with hypothermic cardiocirculatory instability. 2118 75