Günther Sumann
Grenzen der Kältetoleranz The limits of human tolerance to cold S U M M A RY The limits of human tolerance to cold are definitely not known. The reaction of exposition to coldness shows a wide difference between individuals according to their physical and mental condition. Cold associated with wetness and wind is a dangerous combination leading to a rapid cooling of the body. Four case reports, from personal experience and literature presented, report extreme cases of patients with hypothermic cardiac arrest. The lowest core temperature reported, that was ever survived after hypothermic circulatory arrest was 13,7°C. It is unclear whether anybody will be able to survive a lower temperature in the future. The influence of predisposing factors to cold injuries is shown, and the difficulty of prognostic statements is discussed. It is important to know the clinical symptoms of hypothermia and frostbites. Frostbite is usually, but not obligatory associated with hypothermia. The prehospital management is based on immobilisation, isolation and re-warming. It is essential to treat the affected persons very accurately and to not move them more than necessary, in order to prevent circulatory arrest in the course of the rescue operation. The frequently occurring cases with very good outcome after severe hypothermia and hypothermic cardiac arrest are worth the very strong efforts in the treatment of these patients. Keywords: hypothermia, frostbite, circulatory arrest, prehospital management
Z U S A M M E N FA S S U N G Die Grenzen der Kältetoleranz beim Menschen sind nicht klar definierbar. Die Reaktion auf Kälteexposition unterliegt großen individuellen Unterschieden je nach körperlicher und mentaler Konstitution des Betroffenen. Kälte in Kombination mit Nässe und Wind ergeben eine sehr gefährliche Kombination, die zu schneller Auskühlung führt. Anhand von vier Fallbeispielen aus eigener Erfahrung und aus der Literatur werden verschiedene Extremfälle von Patienten mit Kreislaufstillstand in Hypothermie geschildert. Die tiefste, schadenfrei überlebte, dokumentierte Kerntemperatur bei Kreislaufstillstand beträgt 13,7°C. Es
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