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Adult respiratory distress syndrome and disseminated intravascular coagulation complicating heat stroke.

Fifty two consecutive patients with heat stroke were examined for evidence of adult respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). Twelve patients were found to have ARDS (incidence of 23 percent) of whom nine (75 percent) died. All of these 12 patients had DIC as compared to only one among the 40 patients without ARDS. Review of the evidence in literature linking ARDS and DIC and our own observations in this study lead to the conclusion that the coagulopathy may be an essential mediator of lung damage in heat stroke and is a reliable marker of its occurrence. This suggests the possibility that screening of heat stroke victims for DIC may identify patients at increased risk of developing overt ARDS and allow early institution of measures which may possibly improve survival.

Adult↗

Mortality in 13 French cities during the August 2003 heat wave.

We observed the daily trend in mortality rates during the 2003 heat wave in 13 of France's largest cities. Mortality data were collected from July 25 to September 15 each year from 1999 through 2003. The conjunction of a maximum temperature of 35 degrees C and a minimum temperature of 20 degrees C was exceptional in 7 cities. An excess mortality rate was observed in the 13 towns, with disparities from +4% (Lille) to +142% (Paris).

Body Temperature↗

Municipal heat wave response plans.

Approximately 400 people die from extreme heat each year in the United States, and the risk of heat waves may increase as a result of global climate change. Despite the risk of heat-related morbidity and mortality, many cities lack written heat response plans. In a review of plans from 18 cities at risk for heat-related mortality, we found that many cities had inadequate or no heat response plans. This is an important area for further investigation and government attention.

Heat Stroke↗

George.

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Anecdotes as Topic↗

Heat illness.

Heat stroke is reviewed in detail. Particular attention is paid to diagnosis and current emergency department treatment, and a brief overview of pathophysiology is included. Early complications, with recommendations for prevention and management, are described. Minor heat related syndromes are also mentioned.

Diagnosis, Differential↗

[The early prognostic assessment of heat stroke].

We study the clinical characteristics of 21 heat strokes at admittance, to analyze the clinical features in relationship with prognosis. 15 patients (71%) suffered a classical heat stroke and 6 (29%) an active heat stroke. Global mortality was 33%. Sun exposition was more frequent in patients who survived (p less than 0.05), fact that we relate with earlier withdrawal from noxa. Patients with worse prognosis were showing more frequently coma (p less than 0.05); photomotor (p less than 0.01), oculocephalic (p less than 0.01) and corneal (p less than 0.01) reflexes abolition; together with disorders in spontaneous and induced motility of members (p less than 0.05); areflexia (p less than 0.01) and plantar extensor response (p less than 0.05). However the most discriminatory parameter between the two groups was the response to cooling, because the outcome was always fatal when cooling did not take place (p less than 0.01). From the analytical standpoint, serum bicarbonate was lower in the patients who died (p less than 0.05). We insist in the need to start prevention and treatment programs in those communities with high incidence of this syndrome.

Age Factors↗

Heat reactions.

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Heat Exhaustion↗