Initiation of the COST Action HypothermiaNet about survival for hypothermic patients and increased therapeutic use of hypotermia.

Research on rewarming of hypothermic patients has identified 3 significant challenges that threatens their survival: 1) Rewarming shock is a low output heart failure that occurs during rewarming and is characterized by a sudden drop in cardiac output and peripheral arterial pressure. Recent research has established that classical drugs like adrenalin, which support cardiac function in normothermic patients, have a vanished or negative effect during hypothermia. Adrenalin is however a part of the European guidelines for how to treat these patients. Better understanding of the pathophysiology and development of effective treatment strategies is therefore of high importance. 2) Arrhythmias are very common in hypothermic patients and range from atrial fibri llation to life threatening ventricular arrhythmias like ventricular fibrillation. Research in this area is still concentrating on the pathophysiology causing hypothermic arrhythmias. It is necessary cooperate across Europe to create new and use existing models to find out how to prevent, or treat ventricular arrhythmias that result in cardiac arrest and death of hypothermic patients. 3) Bleeding is a very serious complication in hypothermic patients and is especially dangerous in trauma patients, which often are hypothermic and have crush injuries that cause bleeding. In cold blood, function of the blood platelets that normally inhibits bleeding by coagulation, is impaired. Bleedings in hypothermic patients are therefore very challenging to stop and pro bably contributes to that hypothermic trauma patients have three times higher mortality than normothermic trauma patients. Efforts have especially targeted the pathophysiology behind and treatment of rewarming shock, which is a significant threat when re warming hypothermic patients. This COST Action wants to increase the efforts in investigating what kills hypothermic patients and identify methodologies which keeps hypothermic patients alive.