Pathophysiological factors underlying heatstroke

Yan, You-e; Zhao, Yong-Qi; Wang, Hui; Fan, Ming

doi:10.1016/j.mehy.2005.12.048

Cited by 101 publications

(77 citation statements)

References 48 publications

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“…The hypermetabolic state during hyperthermia has been implicated in the pathogenesis of the heat stroke. Heat stroke is characterized by the development of cerebral ischemic injury following severe heat exposure (30,31). The ambient temperature (38.5°C) used in this study was significantly lower compared with that used in heat-stroke models in rats (43°C) (32) and mice (41.8°C) (33).…”

Section: Discussionmentioning

confidence: 97%

Systemic Hyperthermia Induces Ischemic Brain Injury in Neonatal Mice With Ligated Carotid Artery and Jugular Vein

et al. 2007

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Postnatal d 7 (p7) or p12 mice had their right carotid artery (CA) and jugular vein (JV) ligated to mimic veno-arterial (VA) access for extracorporeal membrane oxygenation (ECMO). At p9 -11 (early) or p19 -21 (late) mice were exposed to hyperthermia or normothermia followed by assessment of neuropathological injury score. In separate cohorts of mice, cerebral and peripheral blood flow (CBF, PBF) and cerebral ATP content was measured. Hyperthermia resulted in ischemic brain injury in 57% and 77% of mice subjected to early or late hyperthermia, respectively. Isolated CAϩJV ligation induced minimal injury (score 0.47 Ϯ 0.34) in 2/8 mice from the late normothermia group. No cerebral injury was detected in mice subjected to early normothermia. In 3/19 shams (2/10 early, 1/9 late) hyperthermia induced a subtle (score, 0.6 Ϯ 0.27) injury in the ipsilateral to the site of surgery cortex. CBF and PBF increased in response to hyperthermia in all mice. The rise in CBF was significantly attenuated in the "ligated" versus intact hemisphere, which was associated with a profound depletion of ATP content. Systemic hyperthermia induces ischemic brain injury in mice with ligated CAϩJV. We speculate that hyperthermia/fever can be a potential risk factor for brain injury in infants treated with VA ECMO.

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Section: Discussionmentioning

confidence: 97%

Systemic Hyperthermia Induces Ischemic Brain Injury in Neonatal Mice With Ligated Carotid Artery and Jugular Vein

et al. 2007

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“…However, even nonlethal hyperthermia can lead to a whole range of detrimental effects, which include elevated protein damage, increased inflammatory responses, apoptosis, increased DNA damage in germ cells, oxidative stress, mitochondrial dysfunction, liver damage, cerebral ischaemia, disrupted blood-brain barrier function and embryonic death in pregnant females (e.g. Arnaud et al, 2002;McAnulty et al, 2005;Yan et al, 2006;Chang et al, 2007;Lee et al, 2008;Hansen, 2009). In contrast, mild hypothermia appears to bring a range of benefits including neuroprotection (Salerian and Saleri, 2006;Cheng et al, 2008;Salerian and Saleri, 2008) and enhanced lifespan (Conti et al, 2006;Conti, 2008).…”

Section: New Ideas On Limits To Sustained Energy Intakementioning

confidence: 99%

Limits to sustained energy intake. XIII. Recent progress and future perspectives

Speakman

Król

2011

Journal of Experimental Biology

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Summary Several theories have been proposed to explain limits on the maximum rate at which animals can ingest and expend energy. These limits are likely to be intrinsic to the animal, and potentially include the capacity of the alimentary tract to assimilate energy – the ‘central limitation’ hypothesis. Experimental evidence from lactating mice exposed to different ambient temperatures allows us to reject this and similar ideas. Two alternative ideas have been proposed. The ‘peripheral limitation’ hypothesis suggests that the maximal sustained energy intake reflects the summed demands of individual tissues, which have their own intrinsic limitations on capacity. In contrast, the ‘heat dissipation limit’ (HDL) theory suggests that animals are constrained by the maximal capacity to dissipate body heat. Abundant evidence in domesticated livestock supports the HDL theory, but data from smaller mammals are less conclusive. Here, we develop a novel framework showing how the HDL and peripheral limitations are likely to be important in all animals, but to different extents. The HDL theory makes a number of predictions – in particular that there is no fixed limit on sustained energy expenditure as a multiple of basal metabolic rate, but rather that the maximum sustained scope is positively correlated with the capacity to dissipate heat.

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“…A high ambient temperature may cause varied systemic disorders involving dehydration, electrolyte, and circulatory disorders depending on the conditions of subjects and environments [23,24]. Fatal hyperthermia (heat stroke) usually involves systemic metabolic deterioration, and Wnally causes advanced multiple organ dysfunctions involving skeletal muscle damage, leading to a fatal outcome without accompanying marked inXammatory responses [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Postmortem serum nitrogen compounds and C-reactive protein levels with special regard to investigation of fatal hyperthermia

Maeda

Zhu

Bessho

et al. 2008

Forensic Sci Med Pathol

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The present study analyzed serum levels of urea nitrogen (UN), creatinine (Cr), and C-reactive protein (CRP), which are very stable during the early postmortem period, for investigation of the cause of death with special regard to hyperthermia (heat stroke) in serial medico-legal autopsy cases (n = 429), excluding fatal injury, intoxication, and fire fatality. In this series, mechanical asphyxiation, drowning, and sudden cardiac death cases (n = 56, n = 43, and n = 212, respectively) usually showed low levels within postmortem reference ranges for these serum markers, although UN and CRP levels were mildly elevated in cases of sudden cardiac death and cerebrovascular stroke. There were concomitant significant elevations in serum levels of UN (>50 mg/dL), Cr (>2 mg/dL), and CRP (>2 mg/dL) for chronic renal failure, gastrointestinal bleeding, pneumonia, and hypothermia (cold exposure). UN and CRP were especially high for chronic renal failure and pneumonia, respectively. However, hyperthermia cases showed an isolated elevation in the serum Cr level, suggesting an influence of systemic skeletal muscle damage. These serum markers may be practically useful for postmortem investigation of death due to hyperthermia (heat stroke), for which specific pathological and toxicological evidence may not be available.

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Pathophysiological factors underlying heatstroke

Cited by 101 publications

References 48 publications

Systemic Hyperthermia Induces Ischemic Brain Injury in Neonatal Mice With Ligated Carotid Artery and Jugular Vein

Systemic Hyperthermia Induces Ischemic Brain Injury in Neonatal Mice With Ligated Carotid Artery and Jugular Vein

Limits to sustained energy intake. XIII. Recent progress and future perspectives

Postmortem serum nitrogen compounds and C-reactive protein levels with special regard to investigation of fatal hyperthermia

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