Abstract
Background: The treatment of hypothermic patients suffering from severe trauma is challenging, mainly because of coagulation disorder and potential hemodynamic instability either caused by hemorrhage or accidental hypothermia. Case presentation: We report a single case of an otherwise healthy man who sustained multiple injuries combined with severe accidental hypothermia (< 26o C) in the French Alps. Rewarming was initiated very early in the trauma assessment and before surgical interventions. Despite the very low core temperature, the patient was hemodynamically stable and therefore did not qualify for extracorporeal life support ECLS. In-hospital rewarming consisted of minimally invasive, active external rewarming. Surgical interventions were postponed because of a coagulopathy, caused by severe accidental hypothermia. Conclusions: In selected cases, correction of hypothermia and associated coagulation disorders before surgical interventions might improve the chances for survival in hypothermic trauma patients. Thromboelastography (TEG) in the emergency department might be useful to assess hypothermia-associated coagulopathies.