Eps 1: Severe heat stroke with multiple organ dysfunction
— Case 2
We report an unusual case of multiple organ failure that was caused by classical, nonexertional heat stroke due to taking a warm bath at home.
Although mild or moderate hepatic injury is common, there are only rare reports on fulminant hepatic failure with a rapid decrease in the coagulation parameters from exertional heat stroke, and fulminant hepatic failure from classical, nonexertional heat stroke has never been reported.
We report on an unusual case of multiple organ dysfunction syndrome leading to fulminant hepatic failure, ARF and DIC following a nonexertional heat stroke that was caused by a warm bath.
Host
Ken Robinson
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When the ambulance arrived, the patient showed signs of severe heat stroke with multiple organ dysfunction and was in a state of rapid cooling and rapid resuscitation with intravenous fluid. On admission to the intensive care unit, he was intubated by emergency doctors and still suffered from hypotension, which required a longer course of fluid therapy. Heat stroke in rats is similar to the clinical manifestations of a heat stroke patient and has a high core body temperature, accompanied by heart abnormalities and dysfunction of several organs.
Platelet loss and vascular hyporeactivity improved only partially, but not at the same rate as in heat stroke patients.
Hyperthermia is a potentially dangerous condition that can cause severe multiple organ failure, including brain damage. The results suggest that while istradefylline had a positive effect on mortality rates in heat stroke patients with multiple organ dysfunction, the effect was not sufficient to counteract multiorgan dysfunction and mortality. However, it had a significant effect in the treatment of multiple kidney failure and multiple liver failure.
Hyperthermia is thought to occur in patients who collapse on a hot day because of factors that would hinder cooling, such as lack of oxygen, heat exhaustion and heat stroke.
These case reports illustrate the brain's vulnerability to high temperatures and show that diagnosis is difficult. Treatment of severe heat stroke with multiple organ dysfunction, in which controlled normothermia and therapeutic hypotheria are superior, should be initiated. If several organs are dysfunctional, a targeted temperature control with a combination of hyperthermia, hyperoxygenation and anti-heat therapy should be carried out even in the first hours.
Butterfelter et al., 2014, "Treatment of severe heat stroke with multiple organ dysfunction: a systematic review of literature."
Successful management of heat stroke is associated with the use of a physiological body cooling unit, such as a heat exchanger, in patients with multiple organ dysfunction.
Heat stroke causes the body to overheat due to the persistent exposure to high temperatures, such as the heat of the sun. Heat stroke can lead to organ failure and death if not treated quickly, and can occur once the body temperature rises to 104 degrees or higher.
Excitement heat stroke is a life-threatening condition caused by excess heat that occurs during muscle training and exceeds the body's ability to discharge itself at the same rate. Anyone can suffer from heat stroke or heat exhaustion, as it can occur at any time of the day or night, even without physical activity. Acute liver failure and heat stroke are life-threatening conditions with often delayed onset, which in most cases are nevertheless resolved with supportive care. Delayed referral for transplant therefore seems reasonable, but the risk of death increases over time.
It is a form of hyperthermia, which is accompanied by a systemic inflammatory reaction that leads to a syndrome of multi-organ dysfunction in which encephalopathy prevails.
Typical organ dysfunction is the disseminated intravascular clotting of the liver, kidneys and other organs. This reaction can lead to the development of a number of inflammatory reactions in the blood, including inflammatory bowel disease, the spread of intravenous coagulation, inflammation of blood vessels and clots, pulmonary embolism and pulmonary edema, and a host of other complications.
Severe heat stroke can also be fatal after lowering the body temperature of the person affected. Those who survive can suffer permanent nerve damage, and even in the most severe cases, severe heat stroke can be fatal as a result of lower body temperatures and blood pressure.
Global warming increases the risk of heat stroke, the most serious heat illness. The mortality of patients with heat stroke is due to multiple organ failure caused by a systemic inflammatory reaction. This is similar to sepsis, but the mortality rate for patients in the US increases dramatically with global warming.
We investigated whether the new A2A receptor antagonist isostylline had a positive effect on heat stroke in rats.
The American physician Silas Mitchell described in 1874 a novel form of headache after prolonged, frequent and direct exposure to the sun at work. Interestingly, few authors have reported that survivors of EHI can also develop new chronic headaches. Mitchell was described as a headache that could be triggered or exacerbated by exertion and exposure to the sun in a hot environment in patients.
Recently, Di Lorenzo et al reported that a 45-year-old woman developed new persistent severe headaches after a heat stroke. A physically fit young man suffered a severe and life-threatening heat stroke after a 10km road race.