Heat stroke

Abstract

Heat-related illness includes heat cramps, heat syncope, heat exhaustion and heatstroke. Untreated heat exhaustion can progress to heatstroke, a life-threatening illness characterized by an elevated core body temperature (> 40 °C) and dysfunction of central nervous system, which results in delirium, convulsions, or coma. Hyperthermia associated with the acute physiological alterations, thermoregulatory failure, systemic inflammatory response, attenuated heat-shock response and the cytotoxicity of heat leading to progression of heat stroke. The prognosis of heat stroke in petients is directly related to the duration of hyperthermia. The prognosis is poorest when treatment is delayed > 2 hours. Therefore, the most important feature in the treatment of heat stroke is rapid cooling. The prognosis is optimal when heat stroke is diagnosed early and management with effective and easy cooling measures (including immersion in water, evaporative cooling) begins promptly. Long-term neurologic sequelae occur in approximately 20% of patients. New approaches to reduce mortality and complication of heat stroke are being studied.