Cooling Methods in Heat Stroke
- PMID:26525947
- DOI: 10.1016/j.jemermed.2015.09.014
Cooling Methods in Heat Stroke
Abstract
Background: Heat stroke is an illness with a high risk of mortality or morbidity, which can occur in the young and fit (exertional heat stroke) as well as the elderly and infirm (nonexertional heat stroke). In the United States, from 2006 to 2010, there were at least 3332 deaths attributed to heat stroke.
Objective: To summarize the available evidence on the principal cooling methods used in the treatment of heat stroke.
Discussion: Although it is generally agreed that rapid, effective cooling increases survival in heat stroke, there continues to be debate on the optimal cooling method. Large, controlled clinical trials on heat stroke are lacking. Cooling techniques applied to healthy volunteers in experimental models of heat stroke have not worked as rapidly in actual patients with heat stroke. The best available evidence has come from large case series using ice-water immersion or evaporation plus convection to cool heat-stroke patients.
Conclusions: Ice-water immersion has been shown to be highly effective in exertional heat stroke, with a zero fatality rate in large case series of younger, fit patients. In older patients with nonexertional heat stroke, studies have more often promoted evaporative plus convective cooling. Evaporative plus convective cooling may be augmented by crushed ice or ice packs applied diffusely to the body. Chilled intravenous fluids may also supplement primary cooling. Based on current evidence, ice packs applied strategically to the neck, axilla, and groin; cooling blankets; and intravascular or external cooling devices are not recommended as primary cooling methods in heat stroke.
Keywords: conductive cooling; evaporation and convection cooling; exertional heat stroke; heat stroke treatment; nonexertional heat stroke.
Copyright © 2016 Elsevier Inc. All rights reserved.
Similar articles
- Cooling methods used in the treatment of exertional heat illness.Smith JE.Smith JE.Br J Sports Med. 2005 Aug;39(8):503-7; discussion 507. doi: 10.1136/bjsm.2004.013466.Br J Sports Med. 2005.PMID:16046331Free PMC article.Review.
- Successful Management of Severe Exertional Heat Stroke with Endovascular Cooling After Failure of Standard Cooling Measures.Bursey MM, Galer M, Oh RC, Weathers BK.Bursey MM, et al.J Emerg Med. 2019 Aug;57(2):e53-e56. doi: 10.1016/j.jemermed.2019.03.025. Epub 2019 Apr 17.J Emerg Med. 2019.PMID:31005365
- [Advances in pre-hospital recognition and cooling treatment of exertional heat stroke].Wang H, Chen W, Li S, Wang Z, Wu Y, Li H.Wang H, et al.Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Oct;30(10):1006-1010. doi: 10.3760/cma.j.issn.2095-4352.2018.010.021.Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018.PMID:30439327Review.Chinese.
- First aid cooling techniques for heat stroke and exertional hyperthermia: A systematic review and meta-analysis.Douma MJ, Aves T, Allan KS, Bendall JC, Berry DC, Chang WT, Epstein J, Hood N, Singletary EM, Zideman D, Lin S; First Aid Task Force of the International Liaison Committee on Resuscitation.Douma MJ, et al.Resuscitation. 2020 Mar 1;148:173-190. doi: 10.1016/j.resuscitation.2020.01.007. Epub 2020 Jan 22.Resuscitation. 2020.PMID:31981710Review.
- Exertional heat illness in a Marine training on the endurance course.Rohe ST.Rohe ST.JAAPA. 2012 Jun;25(6):34, 36-8. doi: 10.1097/01720610-201206000-00007.JAAPA. 2012.PMID:22693882
Cited by
- Clinical characteristics, prognostic factors, and outcomes of heat-related illness (Heatstroke Study 2017-2018).Shimazaki J, Hifumi T, Shimizu K, Oda Y, Kanda J, Kondo Y, Shiraishi S, Takauji S, Hayashida K, Moriya T, Yagi M, Yamaguchi J, Yokota H, Yokobori S, Wakasugi M, Yaguchi A, Miyake Y.Shimazaki J, et al.Acute Med Surg. 2020 Jun 16;7(1):e516. doi: 10.1002/ams2.516. eCollection 2020 Jan-Dec.Acute Med Surg. 2020.PMID:32551124Free PMC article.
- Bone marrow-derived mononuclear cell therapy can attenuate systemic inflammation in rat heatstroke.Umemura Y, Ogura H, Matsuura H, Ebihara T, Shimizu K, Shimazu T.Umemura Y, et al.Scand J Trauma Resusc Emerg Med. 2018 Nov 16;26(1):97. doi: 10.1186/s13049-018-0566-2.Scand J Trauma Resusc Emerg Med. 2018.PMID:30445981Free PMC article.
- Heat stroke management during the COVID-19 pandemic: Recommendations from the experts in Japan (2nd edition).Kanda J, Wakasugi M, Kondo Y, Ueno S, Kaneko H, Okada Y, Okano Y, Kishihara Y, Hamaguchi J, Ishihara T, Igarashi Y, Nakae R, Miyamoto S, Yamada E, Ikechi D, Yamazaki M, Tanaka D, Sawada Y, Suda C, Yoshimura S, Onodera R, Kano K, Hongo T, Endo K, Iwasaki Y, Kodaira H, Yasuo S, Seki N, Okuda H, Nakajima S, Nagato T, Terazumi K, Nakamura S, Yokobori S.Kanda J, et al.Acute Med Surg. 2023 Apr 11;10(1):e827. doi: 10.1002/ams2.827. eCollection 2023 Jan-Dec.Acute Med Surg. 2023.PMID:37056485Free PMC article.
- Proteomics Analysis of Proteotoxic Stress Response in In-Vitro Human Neuronal Models.Alaiya A, Alharbi BM, Shinwari Z, Rashid M, Albinhassan TH, Bouchama A, Alwesmi MB, Mohammad S, Malik SS.Alaiya A, et al.Int J Mol Sci. 2024 Jun 20;25(12):6787. doi: 10.3390/ijms25126787.Int J Mol Sci. 2024.PMID:38928492Free PMC article.
- The Exposome and Cardiovascular Health.Motairek I, Makhlouf MHE, Rajagopalan S, Al-Kindi S.Motairek I, et al.Can J Cardiol. 2023 Sep;39(9):1191-1203. doi: 10.1016/j.cjca.2023.05.020. Epub 2023 Jun 6.Can J Cardiol. 2023.PMID:37290538Free PMC article.Review.
Publication types
MeSH terms
Related information
LinkOut - more resources
Full Text Sources
Other Literature Sources