The golden hour in heat stroke: Use of iced peritoneal lavage

Horowitz, B. Zane

doi:10.1016/0735-6757(89)90285-4

Cited by 46 publications

(20 citation statements)

References 16 publications

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“…These have been investigated in animal models, 31-33 but the only data in human subjects come from a case series where gastric lavage is described, 6 and a single case report, when cooling was achieved in a patient resistant to evaporative techniques. 19 The role of invasive cooling methods has therefore not been fully established.…”

Section: Evaporative Methodsmentioning

confidence: 99%

Cooling methods used in the treatment of exertional heat illness

2005

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Objective:To review the different methods of reducing body core temperature in patients with exertional heatstroke.Methods:The search strategy included articles from 1966 to July 2003 using the databases Medline and Premedline, Embase, Evidence Based Medicine (EBM) reviews, SPORTDiscus, and cross referencing the bibliographies of relevant papers. Studies were included if they contained original data on cooling times or cooling rates in patients with heat illness or normal subjects who were subjected to heat stress.Results:In total, 17 papers were included in the analysis. From the evidence currently available, the most effective method of reducing body core temperature appears to be immersion in iced water, although the practicalities of this treatment may limit its use. Other methods include both evaporative and invasive techniques, and the use of chemical agents such as dantrolene.Conclusions:The main predictor of outcome in exertional heatstroke is the duration and degree of hyperthermia. Where possible, patients should be cooled using iced water immersion, but, if this is not possible, a combination of other techniques may be used to facilitate rapid cooling. There is no evidence to support the use of dantrolene in these patients. Further work should include a randomised trial comparing immersion and evaporative therapy in heatstroke patients.

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Section: Evaporative Methodsmentioning

confidence: 99%

Cooling methods used in the treatment of exertional heat illness

2005

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“…Peritoneal dialysis may be used as adjunctive treatment in the management of severe hypothermia or hyperthermia, because rapid peritoneal exchanges of dialysis solution heated to normal body temperature raises body temperature; on the other hand, cold peritoneal solutions have been used to lower core temperature in patients with hyperpyrexia refractory to conventional treatment (28)(29)(30). However, it has not been established whether these manoeuvres improve the prognosis.…”

Section: Hypothermia and Hyperthermiamentioning

confidence: 99%

Peritoneal Dialysis in Acute Renal Failure

Passadakis

2003

Int J Artif Organs

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“…[4][5][6]19,20 Extreme heat affects performance and productivity and predisposes people to societal conflicts, violent crimes, and civil wars. 2,[21][22][23][24] The emerging incidence of heat illnesses in the backdrop of pre-existing morbidities and complications thereof needs active surveillance and threat assessment with pre-determined mathematical models comparable to those of cold injury and altitude illnesses. [25][26][27][28] This study was conducted in limited resource tent-clinics, which prevented the detailed assessment of heat illness, complications, differential diagnoses, and documentation due to the overwhelming throughput of patients.…”

Section: Discussionmentioning

confidence: 99%

“…[29][30][31][32] This concept has been elaborated as the "golden hour in heatstroke. " 23 A comprehensive, public health surveillance system enabled Hajj organizers to recognize heatstroke as a significant cause of morbidity, which was noticeably reduced after the provision of gratis potable cold water, sun cover, water sprinklers, and air misters along the pilgrimage routes. [33][34][35] Nevertheless, opportunities exist for intervention in the preparedness, clientele, and technology fronts.…”

Section: Discussionmentioning

confidence: 99%