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Pathophysiology of heat stroke

Author: Lisa R Leon
Publisher: San Rafael, California (1537 Fourth Street, San Rafael, CA 94901 USA) : Morgan & Claypool, 2015.
Series: Colloquium digital library of life sciences.; Colloquium series on integrated systems physiology, # 60.
Edition/Format:   eBook : Document : EnglishView all editions and formats
Summary:
Heat illnesses exist along a continuum starting with the mild condition of heat exhaustion and progressing to heat injury and heat stroke. Heat stroke is a life-threatening condition clinically characterized by a severe elevation in body temperature with central nervous system dysfunction that often includes combativeness, delirium, seizures, and coma. Classic heat stroke is experienced primarily by the very young  Read more...
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Details

Genre/Form: Electronic books
Additional Physical Format: Print version:
Material Type: Document, Internet resource
Document Type: Internet Resource, Computer File
All Authors / Contributors: Lisa R Leon
ISBN: 9781615046836 1615046836 1615046828 9781615046829
OCLC Number: 909812073
Notes: Part of: Colloquium digital library of life sciences.
Title from PDF title page (viewed on May 22, 2015).
Description: 1 online resource (1 PDF (viii, 101 pages)) : illustrations.
Contents: 1. Introduction. 2. Principles of temperature regulation --
2.1 Mechanisms of heat exchange --
2.2 Compensable vs. uncompensable heat stress --
2.3 Set point theory --
2.4 Unregulated vs. regulated changes in body temperature --
2.5 Methods to measure body temperature. 3. Heat illness --
3.1 The heat illness continuum --
3.2 Classic vs. exertional heat stroke --
3.3 Risk factors: skin-out and skin-in --
3.4 Skin disorders and burns. 4. Clinical characteristics of heat stroke --
4.1 Dehydration and acid-base disturbances --
4.2 Hematologic disturbances and coagulopathies --
4.3 Hyperthermia and the concept of thermal area --
4.4 Hypothermia during heat stroke recovery --
4.5 Recurrent hyperthermia during heat stroke recovery: is it a true fever? 5. The systemic inflammatory response to heat stroke --
5.1 Cytokines --
5.1.1 Interleukin-1 --
5.1.2 Interleukin-6 --
5.1.3 Tumor necrosis factor --
5.1.4 Interferon --
5.2 Chemokines --
5.3 Multi-organ injury --
5.3.1 Cardiovascular dysfunction and injury --
5.3.2 Encephalopathy --
5.3.3 Gut epithelial membrane permeability --
5.3.4 Danger signals --
5.3.5 Endotoxemia --
5.3.6 Rhabdomyolysis --
5.3.7 Acute kidney injury --
5.3.8 Acute lung injury --
5.3.9 Liver dysfunction and injury. 6. Biomarkers for organ injury assessment. 7. Adaptive and maladaptive responses --
7.1 Heat acclimatization --
7.2 Heat shock proteins and acquired thermotolerance --
7.3 Malignant hyperthermia --
7.4 Sickle cell trait. 8. Clinical management of heat stroke --
8.1 Ice water immersion --
8.2 Evaporative cooling --
8.3 Non-invasive vs. invasive cooling methods --
8.4 Pharmacologic cooling methods. 9. Emerging directions --
9.1 Improved biomarkers for recovery assessment --
9.2 Intestinal fatty acid-binding proteins --
9.3 Neutrophil gelatinase-associated lipocalin --
9.4 Cardiac troponin. 10. Summary --
Acknowledgments --
References --
Author biography.
Series Title: Colloquium digital library of life sciences.; Colloquium series on integrated systems physiology, # 60.
Responsibility: Lisa R. Leon.
More information:

Abstract:

Heat illnesses exist along a continuum starting with the mild condition of heat exhaustion and progressing to heat injury and heat stroke. Heat stroke is a life-threatening condition clinically characterized by a severe elevation in body temperature with central nervous system dysfunction that often includes combativeness, delirium, seizures, and coma. Classic heat stroke is experienced primarily by the very young or elderly during annual heat waves. Exertional heat stroke is a condition experienced by young, fit individuals during strenuous physical activity in hot or temperate environments. Heat stroke sequelae are a consequence of heat injury to the tissues in combination with coagulopathies and a systemic inflammatory response syndrome (SIRS) that often culminates in multi-organ system dysfunction or death. Endotoxin leakage across ischemic-damaged gut membranes is thought to initiate the SIRS with cytokines and other inflammatory mediators involved in this multi-factorial process. Rapid cooling at the time of heat stroke collapse is the most effective treatment to limit the severity of organ injury, but does not prevent long-term sequelae in all individuals. Unfortunately, there is limited understanding of the mechanisms mediating downstream effects of the SIRS on multi-organ injury and there are no clinical treatments to ensure recovery. Rather, many heat stroke victims experience permanent neurological dysfunction and peripheral organ injury that require months or years to resolve. Current research efforts are focused on identifying better diagnostic and prognostic biomarkers of organ injury for development of more effective pharmacologic strategies to improve recovery.

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