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2018 ; 6
(ä): 30
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Heat stroke
#MMPMID29850022
Hifumi T
; Kondo Y
; Shimizu K
; Miyake Y
J Intensive Care
2018[]; 6
(ä): 30
PMID29850022
show ga
BACKGROUND: Heat stroke is a life-threatening injury requiring neurocritical
care; however, heat stroke has not been completely examined due to several
possible reasons, such as no universally accepted definition or classification,
and the occurrence of heat wave victims every few years. Thus, in this review, we
elucidate the definition/classification, pathophysiology, and prognostic factors
related to heat stroke and also summarize the results of current studies
regarding the management of heat stroke, including the use of intravascular
balloon catheter system, blood purification therapy, continuous
electroencephalogram monitoring, and anticoagulation therapy. MAIN BODY: Two
systems for the definition/classification of heat stroke are available, namely
Bouchama's definition and the Japanese Association for Acute Medicine criteria.
According to the detailed analysis of risk factors, prevention strategies for
heat stroke, such as air conditioner use, are important. Moreover, hematological,
cardiovascular, neurological, and renal dysfunctions on admission are associated
with high mortality, which thus represent the potential targets for intensive and
specific therapies for patients with heat stroke. No prospective, comparable
study has confirmed the efficacy of intravascular cooling devices,
anticoagulation, or blood purification in heat stroke. CONCLUSION: The
effectiveness of cooling devices, drugs, and therapies in heat stroke remains
inconclusive. Further large studies are required to continue to evaluate these
treatment strategies.