Efficacy of blood purification therapy for heat stroke presenting rapid progress of multiple organ dysfunction syndrome: a comparison of five cases

Abstract

Five patients were admitted to our hospital because of classical heat stroke during the heat waves which attacked our country in the summers 1994 and 1995. The clinical and laboratory findings of all patients suggested the rapid progress of multiple organ dysfunction syndrome (MODS). Blood purification (BP) therapy, in addition to conventional treatment, was performed in three of the patients. Despite their disastrous general condition, all completely recovered or recovered sufficiently to be transferred to a rehabilitation hospital. Two additional patients were treated with conventional treatment only and both died in 1-3 days after admission. Clinical characteristics and laboratory findings on admission showed no differences between the cases receiving BP therapy and those not receiving BP therapy. These findings suggest that, in heat stroke patients, additional BP therapy may provide a better prognosis than conventional therapy only. These beneficial effects of BP may have been due mainly to the removal of proinflammatory cytokines related to heat stroke.

Heat Stroke With Multiple Organ Failure Treated With Cold Hemodialysis and Cold Continuous Hemodiafiltration: A Case Report

“…Moreover, the novel strategy in this case was to use cold HD plus cold, high flow CHDF to wash out the patient's internal heat. Our case was more serious in terms of laboratory findings, conscious levels, and the numbers of affected end‐organs than reported cases (5). High flow of cold dialysate increased the efficiency in heat exchange and contributed to the inhibition of a further rise in body temperature and progression of MOF, which had favorable effects in this severe clinical condition.…”

“…By virtue of cold, high flow CHDF, he recovered almost fully regarding neurological, respiratory, hematological and cardiac functions, although mild hepatic and renal failure still remained 3 weeks after the onset. It has already been reported that continuous hemofiltration and plasma exchange might improve survival in heat stroke (5). Ikeda et al.…”

“…The underlying mechanism for the progression of multiple organ damage has not been fully understood (4). A recent clinical trial suggests blood purification therapy as a potential treatment of choice (5).…”

A Case of Multiple Organ Failure due to Heat Stoke Following a Warm Bath

“…al. reported that the heat stroke patients who received blood purification had better clinical outcomes, but there has been a lack of prospective studies that can determine the role of CVVHF for the patients suffering with heat stroke7).…”

Heat Illness - Recent Developments

“…Blood Purification Therapy (BPT) was investigated in a group of five classical heat stroke patients by Ikeda and colleagues (49). The three patients given BPT in conjunction with conventional treatment survived, whilst the two patients given conventional treatment alone both died.…”