Advances in rapid cooling treatment for heat stroke / 解放军医学杂志

ABSTRACT

Heat stroke is a life-threatening disease characterized clinically by central nervous system dysfunction and severe hyperthermia (core temperature rises to higher than 40 °C). The unchecked rise of body core temperature overwhelms intrinsic or extrinsic heat generation mechanism, thus overwhelms homoeostatic thermoregulation. Hyperthermia causes cellular and organ dysfunction with progressive exacerbation resulting in multi-organ failure and death. Rapid cooling to reduce core temperature as quickly as possible is the primary and most effective treatment, as it has been shown that the major determinant of outcome in heatstroke is the degree and duration of hyperthermia. If suppression of body temperature is delayed, the fatality rate will be elevated. Several cooling methods are available, including physical cooling by conduction, convection and evaporation with ice/cold water immersion, internal cooling by invasive methods such as hemofiltration, intravascular cooling, cold water gastric and rectal lavage, and cooling with drugs. It is crucial to formulate a scientific and reasonable strategy for the subsequent treatment in accordance with the patient's physical condition, the condition of cooling equipment, and the manipulator's proficiency in cooling methods and equipment usage. This article reviews the domestic and international advances in study of rapid and efficient cooling measures for heat stroke.