Heat Stroke
Heat Stroke
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DOI：
10.1002/cphy.c140017
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发表时间：
2015-04-01
影响因子：
5.8
通讯作者：
Bouchama, Abderrezak
中科院分区：
文献类型：
--
作者：
Leon, Lisa R.;Bouchama, Abderrezak
中暑是一种危及生命的疾病，临床诊断为体温严重升高，伴有中枢神经系统功能障碍，通常包括好斗、谵妄、癫痫发作和昏迷。典型的中暑主要发生在免疫功能低下的人在每年的热浪。预防性中暑见于在炎热或高温环境中进行剧烈体力活动的年轻健康个体。中暑的长期后果被认为是由于全身炎症反应综合征。本文综述了中暑危险因素的识别、内毒素和细胞因子在多器官损伤中的作用、中暑恢复期体温过低和发热的发生率、器官损伤严重程度的临床生物标志物以及保护性降温策略等方面的最新进展。风险因素包括环境因素、药物治疗、药物使用、健康状况受损和遗传条件。内毒素和细胞因子的作用是在30多年前进行的研究框架中讨论的，需要重新评估，以更清楚地确定这些因素在全身炎症反应综合征中的作用。我们挑战的概念，下丘脑损伤是负责中暑恢复过程中的体温调节紊乱，并强调我们的理解这些反应的调节性质的最新进展。需要更敏感的器官损伤的临床生物标志物进行检查。传统和新兴的冷却方法进行了讨论，参考保护周围器官损伤和选择性脑冷却。2015年出版。
Heat stroke is a life-threatening condition clinically diagnosed as a severe elevation in body temperature with central nervous system dysfunction that often includes combativeness, delirium, seizures, and coma. Classic heat stroke primarily occurs in immunocompromised individuals during annual heat waves. Exertional heat stroke is observed in young fit individuals performing strenuous physical activity in hot or temperature environments. Long-term consequences of heat stroke are thought to be due to a systemic inflammatory response syndrome. This article provides a comprehensive review of recent advances in the identification of risk factors that predispose to heat stroke, the role of endotoxin and cytokines in mediation of multi-organ damage, the incidence of hypothermia and fever during heat stroke recovery, clinical biomarkers of organ damage severity, and protective cooling strategies. Risk factors include environmental factors, medications, drug use, compromised health status, and genetic conditions. The role of endotoxin and cytokines is discussed in the framework of research conducted over 30 years ago that requires reassessment to more clearly identify the role of these factors in the systemic inflammatory response syndrome. We challenge the notion that hypothalamic damage is responsible for thermoregulatory disturbances during heat stroke recovery and highlight recent advances in our understanding of the regulated nature of these responses. The need for more sensitive clinical biomarkers of organ damage is examined. Conventional and emerging cooling methods are discussed with reference to protection against peripheral organ damage and selective brain cooling. Published 2015.