Heat stroke: implications for critical care and anaesthesia

Grogan, Helen A.; Hopkins, Philip M.

doi:10.1093/bja/88.5.700

Cited by 133 publications

(128 citation statements)

References 36 publications

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“…Heat illness while working is called exertional heat illness, which is different from classical heat illness in daily life 20) . Exertional heat illness occurs in healthy young people while exercising, whereas classical heat illness is more likely to occur in the elderly, who are particularly vulnerable 21) . Our study revealed that younger workers are at a higher risk of heat illness.…”

Section: Discussionmentioning

confidence: 99%

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Risk and preventive factors for heat illness in radiation decontamination workers after the Fukushima Daiichi Nuclear Power Plant accident

Kakamu

Hidaka

Hayakawa

et al. 2015

Journal of Occupational Health

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Risk and preventive factors for heat illness in radiation decontamination workers after the Fukushima Daiichi Nuclear Power Plant accident: Takeyasu Kakamu, et al. Department of Hygiene and Preventive Medicine, Fukushima Medical University School of Medicine Objective The aim of this study was to reveal factors related to heat illness in radiation decontamination workers and determine effective preventive measures. Methods A self‐administered questionnaire was sent to 1,505 radiation decontamination workers. The questionnaire included age, sex, duration of decontamination work, previous occupation, education provided by employers regarding heat illness, preventive action against heat illness, and subjective symptoms of heat illness during work. We included 528 men, who replied and answered all questions, in the statistical analysis. Subjective symptoms of heat illness were categorized as “no symptoms”, “Grade I” and “Grade II” according to severity. A multiple linear regression model was used to determine the factors associated with the severity of heat illness. Results The mean age of the subjects was 47.6 years old (standard deviation: 13.4). Of the 528 workers, 316 (59.8%) experienced heat illness symptoms (213 at Grade I and 103 at Grade II). The results of the stepwise selection revealed that age, outdoor manual labor, adequate sleep, use of a cool vest, and salt intake were selected as preventive factors, whereas living in a company dormitory or temporary housing, wearing light clothing, and consuming breakfast were selected as risk factors for heat illness. Conclusions Both working conditions and living environment are associated with heat illness in radiation decontamination workers. Type of housing and sleep are also strongly related to heat illness during work. Employers should consider not only the working conditions of the employee but also the employee's daily living conditions, in order to prevent heat illness.

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Section: Discussionmentioning

confidence: 99%

“…The questionnaire did not cover any questions regarding the medical history or drug use of the workers, even though they are reported to be risk factors associated with heat illness 21,29,31,35) . Additionally, questions regarding working hours or duration of work were not included in the questionnaire.…”

Section: Discussionmentioning

confidence: 99%

Risk and preventive factors for heat illness in radiation decontamination workers after the Fukushima Daiichi Nuclear Power Plant accident

Kakamu

Hidaka

Hayakawa

et al. 2015

Journal of Occupational Health

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“…Though surgical incisions can result in post-operative elevation in blood CK, the rapid intra-operative exponential rise in CK levels, particularly in surgeries with isoflurane anesthesia without cisatracurium, indicate underlying skeletal muscle pathology. While, CK, AST, ALT may remain normal in MH , elevations in AST, ALT, GGT and bilirubin have been described in heat stroke, a close correlative of MH [14][15][16]. Although, heart, liver, skeletal muscle or RBC's could be the source of aminotransferases, the rapid intra-operative elevations in AST in our surgeries, without evident acute liver damage or peripheral RBC lysis, could only be explained by ongoing skeletal muscle damage with dark colored urine (recipients 1 and 2) due to myoglobinuria.…”

Section: Discussionmentioning

confidence: 99%

The Progression of Isoflurane-induced Malignant Hyperthermia and Its Attenuation by Cisatracurium in a Pre-clinical Porcine Model of Heart Transplant

Cao¹

2013

J Anesth Clin Res

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Background: Even after several years of study, the intra-operative diagnosis of Malignant Hyperthermia (MH) and the approach to anesthesia in MH-susceptible individuals has remained a challenge. In this study we present the pre-operative and intra-operative findings of development and progression of MH in a porcine model that was assigned for heart transplants. Methods:Female Yorkshire swine were assigned as either donor or recipient and anesthetized with inhalational isoflurane with or without cisatracurium. The inadvertent development of signs indicating MH, including, alterations required in ventilator/bypass machine settings, arterial and venous blood tests, gross-and histo-pathology, were followed through the surgeries that lasted for variable durations between donors and recipients.Results: Both donors and the recipients were apparently MH-susceptible, and showed systemic intraoperative signs of variable severity, that were greater in longer duration recipient surgeries, and in those in which cisatracurium was not administered. These included features of hypermetabolism such as elevated pCO 2 and serum lactate, increased requirements for O 2 (FIO 2 ), and multi-organ changes, including pulmonary congestion, features of intestinal pseudo-obstruction, and inflammatory infiltrates in livers and hearts. Conclusions:The isoflurane-induced MH progressed temporally in severity with the duration of surgery. Use of cisatracurium was directly beneficial in attenuating and/or delaying the progress of MH.

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“…Der Hitzschlag mit Anstrengung tritt bei hoher Umgebungstemperatur und/oder hoher Luftfeuchtigkeit bei sonst jungen und gesunden Erwachsenen während schwerer, anstrengender Tätigkeit auf [262]. Die Sterblichkeit durch Hitzschlag beträgt zwischen 10 und 50% [263].…”

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Kreislaufstillstand unter besonderen Umständen: Elektrolytstörungen, Vergiftungen, Ertrinken, Unterkühlung, Hitzekrankheit, Asthma, Anaphylaxie, Herzchirurgie, Trauma, Schwangerschaft, Stromunfall

Soar

Perkins

Abbas³

et al. 2010

Notfall Rettungsmed

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Heat stroke: implications for critical care and anaesthesia

Cited by 133 publications

References 36 publications

Risk and preventive factors for heat illness in radiation decontamination workers after the Fukushima Daiichi Nuclear Power Plant accident

Risk and preventive factors for heat illness in radiation decontamination workers after the Fukushima Daiichi Nuclear Power Plant accident

The Progression of Isoflurane-induced Malignant Hyperthermia and Its Attenuation by Cisatracurium in a Pre-clinical Porcine Model of Heart Transplant

Kreislaufstillstand unter besonderen Umständen: Elektrolytstörungen, Vergiftungen, Ertrinken, Unterkühlung, Hitzekrankheit, Asthma, Anaphylaxie, Herzchirurgie, Trauma, Schwangerschaft, Stromunfall

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