Acute and serial hemodynamic measurements in 13 pilgrims (average age, 55.2 ± SD 9.3 years) suffering from heat stroke (average rectal temperature, 41.3 ± 1.0°C) revealed a hyperdynamic circulation pattern and a low total peripheral resistance. Five patients had pulmonary edema with an average cardiac index of 5.29 ± SD 0.56 L/min/m 2 , which was slightly higher than the average cardiac index in the group of eight patients without pulmonary edema, 4.76 ± SD 0.6 L/min/m 2. This higher cardiac index was believed to be due to iatrogenic fluid overload which was hard to accommodate intravascularly with the cooling process raising the peripheral vascular resistance, decreasing the venous capacitance, and redistributing the blood from the dilated circulatory bed in the skin to the central circulation. Our data highlight the fact that there is no major intravascular dehydration in heat stroke. The treatment of choice is cooling. The entire process of "supporting the cardiovascular system" should take into consideration avoidance of fluid overload by rapid intravenous fluid administration. Gradual hydration, allowing time for intracellular compartment repletion after cooling, is more appropriate.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.