Successful management of heat stroke associated with multiple-organ dysfunction by active intravascular cooling

Hamaya, Hideyuki; Hifumi, Toru; Kawakita, Kenya; Okazaki, Tomoya; Kiridume, Kazutaka; Shinohara, Naohide; Abe, Yuko; Takano, Koshiro; Hagiike, Masanobu; Kuroda, Yasuhiro

doi:10.1016/j.ajem.2014.05.056

Cited by 21 publications

(12 citation statements)

References 14 publications

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“…Cooling measures used for on-site emergency treatment can all be used in a hospital setting (refer to on-site emergency treatment). The following are other cooling options [51,75,76]: 1) Temperaturecontrol blankets are convenient to use, simple and effective. The patient lies flat on the cooling blanket and the starting temperature of the blanket is set to 38.5°C, the shutdown temperature is 37.5°C, and the surface temperature of the blanket is 4°C; An ice cap or ice pillow can be used simultaneously to achieve rapid cooling.…”

Section: Effective Body Temperature Controlmentioning

confidence: 99%

Expert consensus on the diagnosis and treatment of heat stroke in China

et al. 2020

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Heat stroke (HS) is a fatal disease caused by thermal damage in the body, and it has a very high mortality rate. In 2015, the People's Liberation Army Professional Committee of Critical Care Medicine published the first expert consensus on HS in China, Expert consensus on standardized diagnosis and treatment for heat stroke. With an increased understanding of HS and new issues that emerged during the HS treatment in China in recent years, the 2015 consensus no longer meet the requirements for HS prevention and treatment. It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage, is more practical and is more in line with China's national conditions. This new expert consensus includes new concept of HS, recommendations for laboratory tests and auxiliary examinations, new understanding of diagnosis and differential diagnosis, On-site emergency treatment and In-hospital treatment, translocation of HS patients and prevention of HS.

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Section: Effective Body Temperature Controlmentioning

confidence: 99%

Expert consensus on the diagnosis and treatment of heat stroke in China

et al. 2020

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“…However, a number of HS clinical criteria indicate that this condition also results in the occurrence of multiple organ failure (MOF), leading to death, and is treated using several kinds of cooling treatment and other management approaches [6,7,8,9,10,11,12]. However, the B-HS criteria only include the development of central nervous system disorders due to HS, and death cases may not be attributed to HS because other organ damage markers are not included in the criteria.…”

Section: Introductionmentioning

confidence: 99%

Comparison between the Bouchama and Japanese Association for Acute Medicine Heatstroke Criteria with Regard to the Diagnosis and Prediction of Mortality of Heatstroke Patients: A Multicenter Observational Study

Kondo

Hifumi

Shimazaki

et al. 2019

IJERPH

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Background: This study aims to compare the Bouchama heatstroke (B-HS) and Japanese Association for Acute Medicine heatstroke (JAAM-HS) criteria with regard to the diagnosis and prediction of mortality and neurological status of heatstroke patients. Methods: This multicenter observational study recruited eligible patients from the emergency departments of 110 major hospitals in Japan from 1 July to 30 September, 2014. Results: A total of 317 patients (median age, 65 years; interquartile range, 39–80 years) were included and divided into the B-HS, JAAM-HS, and non-HS groups, with each group consisting of 97, 302, and 15 patients, respectively. The JAAM-HS (1.0; 95% confidence interval [CI], 0.87–1.0) and B-HS (0.29; 95% CI, 0.14–0.49) criteria showed high and low sensitivity to mortality, respectively. Similarly, the JAAM-HS (1.0; 95% CI, 0.93–1.0) and B-HS (0.35; 95% CI, 0.23–0.49) criteria showed high and low sensitivity to poor neurological status, respectively. Meanwhile, the sequential organ failure assessment (SOFA) scores demonstrated good accuracy in predicting mortality among heat-related illness (HRI) patients. However, both JAAM-HS and B-HS criteria could not predict in-hospital mortality. The AUC of the SOFA score for mortality was 0.83 (day 3) among the HRI patients. The patients’ neurological status was difficult to predict using the JAAM-HS and B-HS criteria. Concurrently, the total bilirubin level could relatively predict the central nervous system function at discharge. Conclusions: The JAAM-HS criteria showed high sensitivity to mortality and could include all HRI patients who died. The JAAM-HS criterion was considered a useful tool for judgement of admission at ED. Further investigations are necessary to determine the accuracy of both B-HS and JAAM-HS criteria in predicting mortality and neurological status at discharge.

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“…However, a few cases have reported the use of intravascular cooling for heat stroke [ 41 , 42 ]. Hamaya et al have reported for the first time a good recovery in a case of severe heat stroke, followed by multiple organ dysfunction, which was successfully treated through initial intravascular cooling [ 12 ]. In this case, at an average rate of 0.1 °C/min, the core temperature of the patient’s body reached 38.8 °C after just 17 min.…”

Section: Treatmentmentioning

confidence: 99%

Heat stroke

et al. 2018

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

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Successful management of heat stroke associated with multiple-organ dysfunction by active intravascular cooling

Cited by 21 publications

References 14 publications

Expert consensus on the diagnosis and treatment of heat stroke in China

Expert consensus on the diagnosis and treatment of heat stroke in China

Comparison between the Bouchama and Japanese Association for Acute Medicine Heatstroke Criteria with Regard to the Diagnosis and Prediction of Mortality of Heatstroke Patients: A Multicenter Observational Study

Heat stroke

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