Hypothermia pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Pathophysiology
- Normal body temperature in humans is 37°C (98.6°F). Hypothermia can be divided into three stages of severity.
- In stage 1, body temperature drops by 1-2°C below normal temperature (1.8-3.6°F). Mild to strong shivering occurs. Blood vessels in the outer extremities constrict, lessening heat loss to the outside air. Breathing becomes quick and shallow. Goose bumps form, raising body hair on end in an attempt to create an insulating layer of air around the body (this is of limited use in humans due to lack of sufficient hair, but it can be useful in other species). Often, a person will experience a warm sensation, as if they have recovered, but they are in fact heading into Stage 2. Another test to see if the person is entering stage 2 is if they are unable to touch their thumb with their little finger; this is the first stage of poor muscle coordinaton.
- In stage 2, body temperature drops by 2-4°C (3.6-7.2°F). Shivering becomes more violent. Muscle mis-coordination becomes apparent. Movements are slow and labored, accompanied by a stumbling pace and mild confusion, although the victim may appear alert. Surface blood vessels contract further as the body focuses its remaining resources on keeping the vital organs warm.
- In stage 3, body temperature drops below approximately 32°C (90°F). Shivering usually stops. Cellular metabolic processes shut down. Major organs fail. Clinical death occurs. Because of decreased cellular activity in stage 3 hypothermia, the body will actually take longer to undergo brain death.