Heat stroke

doi:10.1186/s40560-018-0298-4

Review

. 2018 May 22:6:30.

doi: 10.1186/s40560-018-0298-4. eCollection 2018.

Heat stroke

Toru Hifumi^{1

2}, Yutaka Kondo³, Keiki Shimizu⁴, Yasufumi Miyake⁵

Affiliations

¹ 1Emergency Medical Center, Kagawa University Hospital, 1750-1 Ikenobe, Miki, Kita, Kagawa 761-0793 Japan.
² 5Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560 Japan.
³ 2Department of Emergency and Critical Care Medicine, Juntendo University, Urayasu Hospital, 2-1-1 Tomioka,Urayasu-shi, Chiba, 279-0021 Japan.
⁴ Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Centre, 2-8-29 Musashidai, Fuchu-shi, Tokyo, 183-8524 Japan.
⁵ 4Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8606 Japan.

PMID: 29850022
PMCID: PMC5964884
DOI: 10.1186/s40560-018-0298-4

Review

Heat stroke

Toru Hifumi et al. J Intensive Care. 2018.

. 2018 May 22:6:30.

doi: 10.1186/s40560-018-0298-4. eCollection 2018.

Authors

Toru Hifumi^{1

2}, Yutaka Kondo³, Keiki Shimizu⁴, Yasufumi Miyake⁵

Affiliations

¹ 1Emergency Medical Center, Kagawa University Hospital, 1750-1 Ikenobe, Miki, Kita, Kagawa 761-0793 Japan.
² 5Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560 Japan.
³ 2Department of Emergency and Critical Care Medicine, Juntendo University, Urayasu Hospital, 2-1-1 Tomioka,Urayasu-shi, Chiba, 279-0021 Japan.
⁴ Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Centre, 2-8-29 Musashidai, Fuchu-shi, Tokyo, 183-8524 Japan.
⁵ 4Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8606 Japan.

PMID: 29850022
PMCID: PMC5964884
DOI: 10.1186/s40560-018-0298-4

Abstract

Background: Heat stroke is a life-threatening injury requiring neurocritical care; however, heat stroke has not been completely examined due to several possible reasons, such as no universally accepted definition or classification, and the occurrence of heat wave victims every few years. Thus, in this review, we elucidate the definition/classification, pathophysiology, and prognostic factors related to heat stroke and also summarize the results of current studies regarding the management of heat stroke, including the use of intravascular balloon catheter system, blood purification therapy, continuous electroencephalogram monitoring, and anticoagulation therapy.

Main body: Two systems for the definition/classification of heat stroke are available, namely Bouchama's definition and the Japanese Association for Acute Medicine criteria. According to the detailed analysis of risk factors, prevention strategies for heat stroke, such as air conditioner use, are important. Moreover, hematological, cardiovascular, neurological, and renal dysfunctions on admission are associated with high mortality, which thus represent the potential targets for intensive and specific therapies for patients with heat stroke. No prospective, comparable study has confirmed the efficacy of intravascular cooling devices, anticoagulation, or blood purification in heat stroke.

Conclusion: The effectiveness of cooling devices, drugs, and therapies in heat stroke remains inconclusive. Further large studies are required to continue to evaluate these treatment strategies.

Keywords: Anticoagulation; Blood purification therapy; Core body temperature; Heat stroke; Intravascular cooling; JAAM criteria.

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Conflict of interest statement

Not applicableThe authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

**Fig. 1**
Japanese Association of Acute Medicine Heat-Related Illness criteria. DIC, disseminated intravascular coagulation; JCS, Japan Coma Scale

See this image and copyright information in PMC

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References

1. Gaudio FG, Grissom CK. Cooling methods in heat stroke. J Emerg Med. 2016;50:607–616. doi: 10.1016/j.jemermed.2015.09.014. - DOI - PubMed
1. Argaud L, Ferry T, Le QH, Marfisi A, Ciorba D, Achache P, Ducluzeau R, Robert D. Short- and long-term outcomes of heatstroke following the 2003 heat wave in Lyon, France. Arch Intern Med. 2007;167:2177–2183. doi: 10.1001/archinte.167.20.ioi70147. - DOI - PubMed
1. Dematte JE, O'Mara K, Buescher J, Whitney CG, Forsythe S, McNamee T, Adiga RB, Ndukwu IM. Near-fatal heat stroke during the 1995 heat wave in Chicago. Ann Intern Med. 1998;129:173–181. doi: 10.7326/0003-4819-129-3-199808010-00001. - DOI - PubMed
1. Naughton MP, Henderson A, Mirabelli MC, Kaiser R, Wilhelm JL, Kieszak SM, Rubin CH, McGeehin MA. Heat-related mortality during a 1999 heat wave in Chicago. Am J Prev Med. 2002;22:221–227. doi: 10.1016/S0749-3797(02)00421-X. - DOI - PubMed
1. Semenza JC, Rubin CH, Falter KH, Selanikio JD, Flanders WD, Howe HL, Wilhelm JL. Heat-related deaths during the July 1995 heat wave in Chicago. N Engl J Med. 1996;335:84–90. doi: 10.1056/NEJM199607113350203. - DOI - PubMed

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[1] Gaudio FG, Grissom CK. Cooling methods in heat stroke. J Emerg Med. 2016;50:607–616. doi: 10.1016/j.jemermed.2015.09.014. - DOI - PubMed

[2] Gaudio FG, Grissom CK. Cooling methods in heat stroke. J Emerg Med. 2016;50:607–616. doi: 10.1016/j.jemermed.2015.09.014. - DOI - PubMed

[3] Argaud L, Ferry T, Le QH, Marfisi A, Ciorba D, Achache P, Ducluzeau R, Robert D. Short- and long-term outcomes of heatstroke following the 2003 heat wave in Lyon, France. Arch Intern Med. 2007;167:2177–2183. doi: 10.1001/archinte.167.20.ioi70147. - DOI - PubMed

[4] Argaud L, Ferry T, Le QH, Marfisi A, Ciorba D, Achache P, Ducluzeau R, Robert D. Short- and long-term outcomes of heatstroke following the 2003 heat wave in Lyon, France. Arch Intern Med. 2007;167:2177–2183. doi: 10.1001/archinte.167.20.ioi70147. - DOI - PubMed

[5] Dematte JE, O'Mara K, Buescher J, Whitney CG, Forsythe S, McNamee T, Adiga RB, Ndukwu IM. Near-fatal heat stroke during the 1995 heat wave in Chicago. Ann Intern Med. 1998;129:173–181. doi: 10.7326/0003-4819-129-3-199808010-00001. - DOI - PubMed

[6] Dematte JE, O'Mara K, Buescher J, Whitney CG, Forsythe S, McNamee T, Adiga RB, Ndukwu IM. Near-fatal heat stroke during the 1995 heat wave in Chicago. Ann Intern Med. 1998;129:173–181. doi: 10.7326/0003-4819-129-3-199808010-00001. - DOI - PubMed

[7] Naughton MP, Henderson A, Mirabelli MC, Kaiser R, Wilhelm JL, Kieszak SM, Rubin CH, McGeehin MA. Heat-related mortality during a 1999 heat wave in Chicago. Am J Prev Med. 2002;22:221–227. doi: 10.1016/S0749-3797(02)00421-X. - DOI - PubMed

[8] Naughton MP, Henderson A, Mirabelli MC, Kaiser R, Wilhelm JL, Kieszak SM, Rubin CH, McGeehin MA. Heat-related mortality during a 1999 heat wave in Chicago. Am J Prev Med. 2002;22:221–227. doi: 10.1016/S0749-3797(02)00421-X. - DOI - PubMed

[9] Semenza JC, Rubin CH, Falter KH, Selanikio JD, Flanders WD, Howe HL, Wilhelm JL. Heat-related deaths during the July 1995 heat wave in Chicago. N Engl J Med. 1996;335:84–90. doi: 10.1056/NEJM199607113350203. - DOI - PubMed

[10] Semenza JC, Rubin CH, Falter KH, Selanikio JD, Flanders WD, Howe HL, Wilhelm JL. Heat-related deaths during the July 1995 heat wave in Chicago. N Engl J Med. 1996;335:84–90. doi: 10.1056/NEJM199607113350203. - DOI - PubMed

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Heat stroke

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Heat stroke

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