Early organ dysfunction course, cooling time and outcome in classic heatstroke

Intensive Care Med. 2009 Aug;35(8):1454-8. doi: 10.1007/s00134-009-1500-x. Epub 2009 Apr 29.

Abstract

Purpose: To describe the course of early organ dysfunction in a cohort of patients admitted in ICU suffering classic heatstroke.

Methods: Prospective observational single-centre cohort study with a 1-year follow-up.

Interventions: None.

Measurements and main results: Clinical and biological data of 22 patients were analysed. Median body temperature on admission was 41.1 degrees C. Respiratory, circulatory, haematological, hepatic and renal function all deteriorated within the first 24 h of admission. ICU-mortality was 63.6%. Cooling time, serum lactate, serum cardiac troponin I and creatinine were significantly higher in non-survivors. Early ICU-mortality (within 7 days of ICU stay) was due to multiple organ failure. Late ICU-mortality was due to neurological disability.

Conclusions: Classic heat stroke may demonstrate a rapidly worsening organ dysfunction course leading to death even though cooling procedures and intensive care management are promptly started.

MeSH terms

  • Aged
  • Cohort Studies
  • Female
  • France / epidemiology
  • Heat Stroke / mortality
  • Heat Stroke / physiopathology*
  • Heat Stroke / therapy
  • Humans
  • Hypothermia, Induced*
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Multiple Organ Failure / mortality
  • Multiple Organ Failure / physiopathology*
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Risk Assessment
  • Time Factors