Treating exertional heat stroke: Limited understanding of the female response to cold water immersion

Abstract

According to an expansive body of research and best practice statements, whole-body cold water immersion is the gold standard treatment for exertional heat stroke. However, as this founding evidence was predominantly drawn from males, the current guidelines for treatment are being applied to women without validation. Given the recognised differences in thermal responses experienced by men and women, all-encompassing exertional heat stroke treatment advice may not effectively protect both sexes. In fact, recent evidence suggests that hyperthermic women cool faster than hyperthermic men during cold water immersion. This raises the question of whether overcooling is risked if the present guidelines are followed. The current mini-review examined the literature on women’s response to cold water immersion as a treatment for exertional heat stroke and aimed to clarify whether the current guidelines have appropriately considered research investigating women. The potential implications of applying these guidelines to women were also discussed.

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“…In addition, women show a greater dependence between a risk of stroke and abdominal obesity, elevated BP and glucose levels [59][60][61]. Also, women have been shown to cool faster than men [62]. These reasons may be responsible for the greater winter risk of strokes in women.…”

Hypoxia exacerbates heat stress effects on the porcine intestinal epithelium in vitro

“…Heat stress negatively impacts human health, as well as animal agriculture (Pearce et al, 2013b;Ghulam Mohyuddin et al, 2022;Rosinger, 2023). Heatwaves and heat-stroke can kill humans and animals, and there are still no standard treatments available aside from cooling and hydration therapies (Hutchins et al, 2022;Wood et al, 2022). Combined with reduced feed intake, HS markedly impacts animal gastrointestinal tract integrity.…”