Are heat stroke patients fluid depleted? Importance of monitoring central venous pressure as a simple guideline for fluid therapy

Classic heat stroke in a desert climate: A systematic review of 2632 cases

“…The search strategy yielded 1401 records, of which 47 studies [12–58] were considered suitable for inclusion in the review (Table S1). Studies were carried out during Hajj between 1962 and 2019, mainly in Mecca province and particularly at the holy sites of Mina and Arafat (Fig.…”

“…These include bleeding symptoms (EPP = 21.8%), DIC (EPP = 21.1%), and neurological complications, ranging from convulsions (EPP = 7.9%) and cerebellar ataxia (EPP = 10.3%) to flaccid paralysis (EPP = 3.4%). Other complications involved the respiratory system (e.g., acute respiratory distress syndrome [ARDS] [EPP = 15.3%], and acute lung injury [33.3%] [42]), the cardiovascular system (e.g., arrhythmia [33%] [37], non‐ST elevation myocardial infarction [20%] [37], and circulatory and heart failure [54, 55]), and the renal system (e.g., renal dysfunction [46.1%] [42], and acute kidney injury [26.7%] [37]). Multiple organ system dysfunction was reported in nearly 14% of patients with HS (EPP = 13.6%).…”

Classic heat stroke in a desert climate: A systematic review of 2632 cases

“…The search strategy yielded 1401 records, of which 47 studies [12–58] were considered suitable for inclusion in the review (Table S1). Studies were carried out during Hajj between 1962 and 2019, mainly in Mecca province and particularly at the holy sites of Mina and Arafat (Fig.…”

“…These include bleeding symptoms (EPP = 21.8%), DIC (EPP = 21.1%), and neurological complications, ranging from convulsions (EPP = 7.9%) and cerebellar ataxia (EPP = 10.3%) to flaccid paralysis (EPP = 3.4%). Other complications involved the respiratory system (e.g., acute respiratory distress syndrome [ARDS] [EPP = 15.3%], and acute lung injury [33.3%] [42]), the cardiovascular system (e.g., arrhythmia [33%] [37], non‐ST elevation myocardial infarction [20%] [37], and circulatory and heart failure [54, 55]), and the renal system (e.g., renal dysfunction [46.1%] [42], and acute kidney injury [26.7%] [37]). Multiple organ system dysfunction was reported in nearly 14% of patients with HS (EPP = 13.6%).…”

Cooling and hemodynamic management in heatstroke: practical recommendations

“…Various target temperatures ranging from 37°C to 40.1°C for safe discontinuation of cooling were used. Five observational studies met the criteria for the assessment of hemodynamic management [ 31 , 34 , 37 - 39 ]. The total number of patients reported in these 19 publications was 556, and these were subjected to further analysis (Tables 2 , 3 , 4 , 5 , 6 ).…”

“…Studies in animal experiments suggest that secondary splanchnic vasodilation mediated by local production of nitric oxide results in cardiovascular collapse and hyperthermia [ 44 , 45 ]. In contrast, the hemodynamic alterations that follow heatstroke have not been completely elucidated [ 31 , 34 , 37 - 39 ].…”

“…The search strategy used for this review yielded five studies on the hemodynamic alterations in heatstroke with monitored response to therapy [ 31 , 34 , 37 - 39 ]. Table 6 presents a summary of data on hemodynamic monitoring and support in heatstroke.…”

Classic heat stroke in a desert climate: A systematic review of 2632 cases

“…The search strategy yielded 1401 records, of which 47 studies [12–58] were considered suitable for inclusion in the review (Table S1). Studies were carried out during Hajj between 1962 and 2019, mainly in Mecca province and particularly at the holy sites of Mina and Arafat (Fig.…”

“…These include bleeding symptoms (EPP = 21.8%), DIC (EPP = 21.1%), and neurological complications, ranging from convulsions (EPP = 7.9%) and cerebellar ataxia (EPP = 10.3%) to flaccid paralysis (EPP = 3.4%). Other complications involved the respiratory system (e.g., acute respiratory distress syndrome [ARDS] [EPP = 15.3%], and acute lung injury [33.3%] [42]), the cardiovascular system (e.g., arrhythmia [33%] [37], non‐ST elevation myocardial infarction [20%] [37], and circulatory and heart failure [54, 55]), and the renal system (e.g., renal dysfunction [46.1%] [42], and acute kidney injury [26.7%] [37]). Multiple organ system dysfunction was reported in nearly 14% of patients with HS (EPP = 13.6%).…”

Cooling and hemodynamic management in heatstroke: practical recommendations

“…Various target temperatures ranging from 37°C to 40.1°C for safe discontinuation of cooling were used. Five observational studies met the criteria for the assessment of hemodynamic management [ 31 , 34 , 37 - 39 ]. The total number of patients reported in these 19 publications was 556, and these were subjected to further analysis (Tables 2 , 3 , 4 , 5 , 6 ).…”

“…Studies in animal experiments suggest that secondary splanchnic vasodilation mediated by local production of nitric oxide results in cardiovascular collapse and hyperthermia [ 44 , 45 ]. In contrast, the hemodynamic alterations that follow heatstroke have not been completely elucidated [ 31 , 34 , 37 - 39 ].…”

“…The search strategy used for this review yielded five studies on the hemodynamic alterations in heatstroke with monitored response to therapy [ 31 , 34 , 37 - 39 ]. Table 6 presents a summary of data on hemodynamic monitoring and support in heatstroke.…”

Classic heat stroke in a desert climate: A systematic review of 2632 cases

“…The search strategy yielded 1401 records, of which 47 studies [12–58] were considered suitable for inclusion in the review (Table S1). Studies were carried out during Hajj between 1962 and 2019, mainly in Mecca province and particularly at the holy sites of Mina and Arafat (Fig.…”

“…These include bleeding symptoms (EPP = 21.8%), DIC (EPP = 21.1%), and neurological complications, ranging from convulsions (EPP = 7.9%) and cerebellar ataxia (EPP = 10.3%) to flaccid paralysis (EPP = 3.4%). Other complications involved the respiratory system (e.g., acute respiratory distress syndrome [ARDS] [EPP = 15.3%], and acute lung injury [33.3%] [42]), the cardiovascular system (e.g., arrhythmia [33%] [37], non‐ST elevation myocardial infarction [20%] [37], and circulatory and heart failure [54, 55]), and the renal system (e.g., renal dysfunction [46.1%] [42], and acute kidney injury [26.7%] [37]). Multiple organ system dysfunction was reported in nearly 14% of patients with HS (EPP = 13.6%).…”

Cooling and hemodynamic management in heatstroke: practical recommendations

“…Various target temperatures ranging from 37°C to 40.1°C for safe discontinuation of cooling were used. Five observational studies met the criteria for the assessment of hemodynamic management [ 31 , 34 , 37 - 39 ]. The total number of patients reported in these 19 publications was 556, and these were subjected to further analysis (Tables 2 , 3 , 4 , 5 , 6 ).…”

“…Studies in animal experiments suggest that secondary splanchnic vasodilation mediated by local production of nitric oxide results in cardiovascular collapse and hyperthermia [ 44 , 45 ]. In contrast, the hemodynamic alterations that follow heatstroke have not been completely elucidated [ 31 , 34 , 37 - 39 ].…”

“…The search strategy used for this review yielded five studies on the hemodynamic alterations in heatstroke with monitored response to therapy [ 31 , 34 , 37 - 39 ]. Table 6 presents a summary of data on hemodynamic monitoring and support in heatstroke.…”