Skip to main content

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1997))

  • 136 Accesses

Abstract

Heatstroke is a condition in medicine that is dramatic and devastating [1–4]. It strikes healthy people suddenly, and many of them die [1–4]. Those who survive the initial insult may sustain permanent neurologic damage [2, 3]. Heatstroke is a health hazard throughout the world [1–5]. Although prevalent in hot countries, it is not uncommon in temperate zones when sudden, short periods of unusually high temperature occur [1, 5]. In Chicago in July 1995, a three-day heat-wave claimed 500 victims [1]. In Makkah, Saudi Arabia, where the long summer climate is intensely hot, there are many fatalities from heatstroke. During the pilgrimage in 1987, 2000 cases were reported, of which 1000 were fatal [4].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Semenza JC, Rubin CH, Falter KH, et al (1996) Heat-related deaths during the July 1995 heat wave in Chicago. N Engl J Med 335: 84–90

    Article  PubMed  CAS  Google Scholar 

  2. Clowes GH Jr, O’Donnell TF Jr (1974) Heatstroke. N Engl J Med 291: 564–567

    Article  Google Scholar 

  3. Knochel JP (1989) Heatstroke and related heatstress disorders. Dis Mon 35: 301–378

    PubMed  CAS  Google Scholar 

  4. Ghaznawi Hi, Ibrahim MA (1987) Heatstroke and heat exhaustion in pilgrims performing the Haj (annual pilgrimage) in Saudi Arabia. Ann Saudi Med 7: 323–326

    Google Scholar 

  5. Jimenez-Mejias ME, Montano Diaz M, Villalonga J, et al (1990) Classical heatstroke in Spain. Analysis of a series of 78 cases. Med Clin (Barc) 94: 481–486

    CAS  Google Scholar 

  6. Anonymous (1989) Endotoxins in heatstroke (editorial). Lancet 2: 1137–1138

    Google Scholar 

  7. Bouchama A, Parhar RS, El-Yazigi A, Sheth K, Al-Sedairy S (1991) Endotoxemia and release of tumor necrosis factor and interleukin-la in acute heatstroke. J Appl Physiol 70: 2640–2644

    PubMed  CAS  Google Scholar 

  8. Gathiram P, Wells MT, Raidoo D, Brock-Utne JG, Gaffin SL (1988) Portal and systemic plasma lipopolysaccharide concentrations in heat-stressed primates. Circ Shock 25: 223–230

    PubMed  CAS  Google Scholar 

  9. Chang DM (1993) The role of cytokines in heatstroke. Immunol Invest 22: 553–561

    Article  PubMed  CAS  Google Scholar 

  10. Lin MT, Kao TY, Jin YT, Chen CF (1995) Interleukin-1 receptor antagonist attenuates the heatstroke-induced neuronal damage by reducing the cerebral ischemia in rats. Brain Res Bull 37: 595–598

    Article  PubMed  CAS  Google Scholar 

  11. Shieh SD, Shiang JC, Lin YF, Shiao WY, Wang JY (1995) Circulating angiotensin-converting enzyme, von Willebrand factor antigen and thrombomodulin in exertional heatstroke. Clin Sci 89: 261–265

    PubMed  CAS  Google Scholar 

  12. Bouchama A, Hammami MM, Haq A, Jackson J, Al-Sedairy S (1996) Evidence of endothelial cell activation/injury in heatstroke. Crit Care Med 24: 1173–1178

    Article  PubMed  CAS  Google Scholar 

  13. Kao TY, Chio CC, Lin MT (1994) Hypothalamic dopamine release and local cerebral blood flow during onset of heatstroke in rats. Stroke 25: 2483–2487

    Article  PubMed  CAS  Google Scholar 

  14. Bosenberg AT, Brock-Utne JG, Gaffin SL, Wells MT, Blake GT (1988) Strenuous exercise causes systemic endotoxemia. J Appl Physiol 65: 106–108

    PubMed  CAS  Google Scholar 

  15. Bouchama A, Hammami M, Rousset F, Shail E, Ohaly Y, Al-Sedairy S (1995) Plasma concentration of IL-10 in heatstroke and heatstress. Am J Respir Crit Care Med 151: A826 (Abst)

    Google Scholar 

  16. Hammami M, Bouchama A, Shail E, Ohaly Y, Rejjal A, Al-Sedairy S (1996) Modulation of endothelial cells and leukocytes activation/adhesion in heatstroke and heatstress. Am J Respir Crit Care Med 153: A637 (Abst)

    Google Scholar 

  17. Gathiram P, Wells MT, Brock-Utne JG, Gaffin SL (1987) Antilipopolysaccharide improves survival in primates subjected to heatstroke. Circ Shock 23: 157–164

    PubMed  CAS  Google Scholar 

  18. Gathiram P, Wells MT, Brock-Utne JG, Gaffin SL (1988) Prophylactic corticosteroid increases survival in experimental heatstroke in primates. Aviat Space Environ Med 59: 352–355

    PubMed  CAS  Google Scholar 

  19. Bouchama A, Cafege A, Devol EB, Labdi O, El-Assil K, Seraj M (1991) Ineffectiveness of dantrolene sodium in the treatment of heatstroke. Crit Care Med 19: 176–180

    Article  PubMed  CAS  Google Scholar 

  20. Malamud N, Haymaker W, Custer RP (1946) Heatstroke: A clinico-pathologic study of 125 fatal cases. Milit Surg 99: 397–449

    CAS  Google Scholar 

  21. Sprung CL (1979) Hemo dynamic alteration of heatstroke in the elderly. Chest 75: 362–366

    Article  PubMed  CAS  Google Scholar 

  22. Costrini AM, Pitt HA, Gustafson AB, Uddin DE (1979) Cardiovascular and metabolic manifestations of heatstroke and severe heat exhaustion. Am J Med 66: 296–302

    Article  PubMed  CAS  Google Scholar 

  23. O’Donnell TF Jr, Clowes GHA Jr (1972) The circulatory abnormalities of heatstroke. N Engl J Med 287: 734–737

    Article  PubMed  Google Scholar 

  24. Dahmash NS, Al Harthi SS, Akhtar J (1993) Invasive evaluation of patients with heatstroke. Chest 103: 1210–1214

    Article  PubMed  CAS  Google Scholar 

  25. Zahger D, Moses A, Weiss AT (1989) Evidence of prolonged myocardial dysfunction in heatstroke. Chest 95: 1089–1091

    Article  PubMed  CAS  Google Scholar 

  26. Sprung CL, Portocarrero CJ, Fernanine AV, Weinberg PF (1980) The metabolic and respiratory alterations of heatstroke. Arch Intern Med 140: 665–669

    Article  PubMed  CAS  Google Scholar 

  27. Hart GR, Anderson RJ, Crumpler CP, Shulkin A, Reed G, Knochel JP (1981) Epidemic classical heatstroke: Clinical characteristics and course of 28 patients. Medicine 61: 189–197

    Article  Google Scholar 

  28. Gaudio R Jr, Abramson N (1968) Heat-induced hyperventilation. J Appl Physiol 25: 742–746

    PubMed  Google Scholar 

  29. Graham BS, Lichtenstein MJ, Hinson JM, Theil GB (1986) Non-exertional heatstroke: Physiologic management and cooling 14 patients. Arch Intern Med 146: 87–90

    Article  PubMed  CAS  Google Scholar 

  30. Bouchama A, Cafege A, Robertson W, Al-Dossary S, El-Yazigi A (1991) Mechanisms of hypophosphatemia in humans with heatstroke. J Appl Physiol 71: 328–332

    PubMed  CAS  Google Scholar 

  31. Bouchama A, Al Hussein K, Adra C, Rezeig M, Al Shail E, Al Sedairy S (1992) Distribution of peripheral blood leukocytes in acute heatstroke. J Appl Physiol 73: 405–409

    PubMed  CAS  Google Scholar 

  32. Bouchama A, Bridey F, Hammami MM, et al (1997) Activation of coagulation and fibrinolysis in heatstroke. Thromb Haemostas (In press)

    Google Scholar 

  33. Bedrak E, Beer G, Furman KI (1964) Fibrinolytic activity and muscular exercise in heat. J Appl Physiol 19: 469–471

    PubMed  CAS  Google Scholar 

  34. El-Kassimi FA, Al-Mashhadani S, Abdullah AK, Akhtar J (1986) Adult respiratory distress syndrome and disseminated intravascular coagulation complicating heatstroke. Chest 90: 571–574

    Article  PubMed  CAS  Google Scholar 

  35. Al Mashhadani SA, GaderAG, Al Harthi SS, Kangav D, Shaheen FA, Bogus F (1994) The coagulopathy of heatstroke: Alterations in coagulation and fibrinolysis in heatstroke patients during the pilgrimage (Haj) to Makkah. Blood Coag Fibrino15: 731–736

    Google Scholar 

  36. Kew M, Bersohn I, Seftel H, Kent G (1970) Liver damage in heatstroke. Am J Med 49: 192–202

    Article  PubMed  CAS  Google Scholar 

  37. Chao TC, Sinniah R, Pakiam JE (1981) Acute heatstroke deaths. Pathology 13: 145–156

    Article  PubMed  CAS  Google Scholar 

  38. Sohal RS, Sun SC, Colcolough HL, Burch GE (1968) Heatstroke: An electron microscopic study of endothelial cell damage and disseminated intravascular coagulation. Arch Intern Med 122: 43–47

    Google Scholar 

  39. Dinarello CA, Cannon JG, Wolff SM (1988) New concepts on the pathogenesis of fever. Rev Infect Dis 10: 168–189

    Article  PubMed  CAS  Google Scholar 

  40. Rowell LB (1983) Cardiovascular aspects of human thermoregulation. Circ Res 52: 367–379

    Article  PubMed  CAS  Google Scholar 

  41. Cannon JG, Kluger MJ (1983) Endogenous pyrogen activity in human plasma after exercise. Science 220: 617–619

    Article  PubMed  CAS  Google Scholar 

  42. Brenner BM, Troy JL, Ballermann BJ (1989) Endothelium-dependent vascular responses. J Clin Invest 84: 1373–1378

    Article  PubMed  CAS  Google Scholar 

  43. Shapiro Y, Alkan M, Epstein Y, Newman F, Magazanik A (1986) Increase in rat intestinal permeability to endotoxin during hyperthermia. Eur J Appl Physiol 55: 410–412

    Article  CAS  Google Scholar 

  44. Hall DM, Buettneer GR, Matthes RD, Gisolfi CV (1994) Hyperthermia stimulates nitric oxide formation: Electron paramagnetic resonance detection of NO-heme in blood. J Appl Physiol 77: 548–553

    Google Scholar 

  45. Burger FJ, Fuhrman FA (1964) Evidence of injury to tissues after hyperthermia. Am J Physiol 206: 1062–1064

    CAS  Google Scholar 

  46. Buckley IK (1972) A light and electron microscopic study of thermally injured cultured cells. Lab Invest 26: 201–209

    PubMed  CAS  Google Scholar 

  47. Burger FJ, Fuhrman FA (1964) Evidence of injury by heat in mammalian tissues. Am J Physiol 206: 1057–1061

    PubMed  CAS  Google Scholar 

  48. Hubbard RW, Bowers WD, Matthew MT, et al (1979) Rat model of acute heatstroke mortality. J Appl Physiol 42: 809–816

    Google Scholar 

  49. Bynum G, Brown J, Dubose D, et al (1979) Increased survival in experimental dog heatstroke after reduction of gut flora. Aviat Space Environ Med 50: 816–819

    PubMed  CAS  Google Scholar 

  50. Bynum GD, Pandolf KB, Schuette WH, et al (1978) Induced hyperthermia in sedated humans and the concept of critical thermal maximum. Am J Physiol 235: R228 - R236

    PubMed  CAS  Google Scholar 

  51. Pettigrew RT, Galt JM, Ludgate CM, Horn DB, Smith AN (1974) Circulatory and biochemical effects of whole body hyperthermia. Br J Surg 61: 727–730

    Article  PubMed  CAS  Google Scholar 

  52. Slovis CM, Anderson GF, Casolaro A (1982) Survival in a heatstroke victim with a core temperature in excess of 46.5° C. Ann Emerg Med 11: 269–271

    Article  PubMed  CAS  Google Scholar 

  53. Gathiram P, Wells MT, Brock-Utne JG, Wessels BC, Gaffin SL (1987) Prevention of endotoxaemia by non-absorbable antibiotics in heat stress. J Clin Pathol 40: 1364–1368

    Article  PubMed  CAS  Google Scholar 

  54. Butkow N, Mitchell D, Laburn H, Kenedi E (1984) Heatstroke and endotoxemia in rabbits. In: Hales JRS (ed) Thermal Physiology. Raven Press, New York, pp 511–514

    Google Scholar 

  55. Graber CD, Reinhold RB, Breman JG, Harley RA, Hennigar GR (1971) Fatal heatstroke. Circulating endotoxin and Uram-negative sepsis as complications. JAMA 216: 1195–1196

    Google Scholar 

  56. Lin MT, Kao TY, Su CF, Hsu SS (1994) Interleukin-1 beta production during the heatstroke in rabbits. Neurosci Lett 174: 17–20

    Article  PubMed  CAS  Google Scholar 

  57. Bouchama A, Al-Sedairy S, Siddiqui S, Shail E, Rezeig M (1993) Elevated pyrogenic cytokines in heatstroke. Chest 104: 1498–1502

    Article  PubMed  CAS  Google Scholar 

  58. Gader AM, Al-Mashhadani SA, Al-Harthy SS (1990) Direct activation of platelets by heat is the possible trigger of the coagulopathy of heatstroke. Br J Haematol 74: 86–92

    Article  PubMed  CAS  Google Scholar 

  59. Weber MB, Blakely JA (1969) The haemorrhagic diathesis of heatstroke. A consumption coagulopathy successfully treated with heparin. Lancet 1: 1190–1192

    Google Scholar 

  60. Meikle AW, Graybill JR (1967) Fibrinolysis and hemorrhage in a fatal case of heatstroke. N Engl J Med 276: 911–913

    Article  PubMed  CAS  Google Scholar 

  61. Perchick JS, Winkelstein A, Shadduck RK (1975) Disseminated intravascular coagulation in heatstroke. Response to heparin therapy. JAMA 231: 480–483

    Google Scholar 

  62. Beard ME, Hickton CM (1982) Haemostasis in heatstroke. Br J Haematol 52: 269–274

    Article  PubMed  CAS  Google Scholar 

  63. Ang C, Dawes J (1964) The effects of hyperthermia on human endothelial monolayers: Modulation of thrombotic potential and permeability. Blood Coag Fibrinol 5: 193–199

    Google Scholar 

  64. Wojta J, Holzer M, Hufnagl P, Christ G, Hoover RL, Binder BR (1991) Hyperthermia stimulated plasminogen activator inhibitor type 1 expression in human umbilical vein endothelial cells in vitro. Am J Pathol 139: 911–919

    PubMed  CAS  Google Scholar 

  65. Schleef RR, Bevilacqua MP, Sawdey M, Gimbrone MA Jr, Loskutoff DJ (1988) Cytokine activation of vascular endothelium. Effects on tissue-type plasminogen activator and type 1 plasminogen activator inhibitor. J Biol Chem 264: 5797–5799

    Google Scholar 

  66. Ware JT, Heistad DD (1993) Platelet-endothelium interactions. N Engl J Med 328: 628–635

    Article  PubMed  CAS  Google Scholar 

  67. Lefor AT, Foster III CE, Sartor W, Engbrecht B, Fabian DF, Silverman D (1994) Hyperthermia increases intercellular adhesion molecule-1 expression and lymphocyte adhesion to endothelial cells. Surgery 116: 214–221

    PubMed  CAS  Google Scholar 

  68. Zimmerman GA, Prescott SM, Mcintyre TM (1992) Endothelial cell interactions with granulocytes: Tethering and signalling molecules. Immunol Today 13: 93–100

    Google Scholar 

  69. Wyndham CH, Strydom NB, Cooke HM, et al (1959) Methods of cooling subjects with hyperpyrexia. J Appl Physiol 14: 771–776

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Bouchama, A. (1997). SIRS in Heatstroke. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1997. Yearbook of Intensive Care and Emergency Medicine, vol 1997. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-13450-4_66

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-13450-4_66

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-13452-8

  • Online ISBN: 978-3-662-13450-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics