Current science on the treatment of acute heat exhaustion

Heat exhaustion is a serious condition that can result from exposure to high temperatures, leading to symptoms such as dehydration, electrolyte disorders, and acute renal failure (Knowlton et al., 2009). It is crucial to differentiate heat exhaustion from more severe conditions like heat stroke, which is often observed in individuals engaging in strenuous physical activity in hot environments (Leon & Bouchama, 2015). Active cooling methods, such as external convective cooling and internal gastric lavage, have been recommended for the treatment of heat stroke and heat exhaustion (Kanda et al., 2021). The COVID-19 pandemic has highlighted the importance of preventive measures and treatments for heat-related illnesses, including heat stroke and heat exhaustion (Kanda et al., 2022).

In the context of acute heat illnesses, it is essential to consider individual cases, such as a rare instance of non-exercise-induced heat stroke leading to acute liver failure (Chen et al., 2014). While technologies like infrared thermometry show promise for monitoring core temperature, further research is needed to validate their use in diagnosing and treating heat exhaustion (Hansen et al., 1996). Additionally, prehospital data can aid in detecting acute heat illnesses, with factors like high heat index and recent exertion increasing the risk of heat exhaustion (Ranadive et al., 2021).

Understanding the progression of heat-related illnesses is crucial, as heat exhaustion can precede more severe conditions like heat stroke (Weigand et al., 2007). Monitoring and classifying patients based on symptoms and laboratory data can help in determining the severity of heat-related illnesses (Yamamoto et al., 2018). Furthermore, interventions like glutamine ingestion have been studied for their potential to modulate lymphocytic responses to exhaustive exercise in hot environments (Zheng et al., 2018).

In conclusion, the treatment of acute heat exhaustion involves a multi-faceted approach that includes active cooling methods, attention to oxygenation, rapid consideration for hypovolemia with IV fluids, individualized care based on symptoms and laboratory findings, and the consideration of underlying conditions that may exacerbate heat-related illnesses. Research into innovative technologies and interventions continues to advance our understanding and management of heat-related conditions.

References:

  • Chen, K., Chen, T., Sue, Y., Chen, T., & Cheng, C. (2014). High-volume plasma exchange in a patient with acute liver failure due to non-exertional heat stroke in a sauna. Journal of Clinical Apheresis, 29(5), 281-283.
    https://doi.org/10.1002/jca.21315
  • Hansen, R., Olds, T., Richards, D., Richards, C., & Leelarthaepin, B. (1996). Infrared thermometry in the diagnosis and treatment of heat exhaustion. International Journal of Sports Medicine, 17(01), 66-70.
    https://doi.org/10.1055/s-2007-972810
  • Kanda, J., Miyake, Y., Umehara, T., Yoshiike, S., Fujita, M., Hayashida, K., … & Yokobori, S. (2022). Influence of the coronavirus disease 2019 (covid‐19) pandemic on the incidence of heat stroke and heat exhaustion in japan: a nationwide observational study based on the heatstrokestudy2019 (withoutcovid‐19) and 2020 (withcovid‐19). Acute Medicine & Surgery, 9(1).
    https://doi.org/10.1002/ams2.731
  • Kanda, J., Nakahara, S., Nakamura, S., Miyake, Y., Shimizu, K., Yokobori, S., … & Sakamoto, T. (2021). Association between active cooling and lower mortality among patients with heat stroke and heat exhaustion. Plos One, 16(11), e0259441.
    https://doi.org/10.1371/journal.pone.0259441
  • Knowlton, K., Rotkin-Ellman, M., King, G., Margolis, H., Smith, D., Solomon, G., … & English, P. (2009). The 2006 california heat wave: impacts on hospitalizations and emergency department visits. Environmental Health Perspectives, 117(1), 61-67.
    https://doi.org/10.1289/ehp.11594
  • Leon, L. and Bouchama, A. (2015). Heat stroke., 611-647.
    https://doi.org/10.1002/cphy.c140017
  • Ranadive, N., Desai, J., Sathish, L., Knowlton, K., Dutta, P., Ganguly, P., … & Hess, J. (2021). Climate change adaptation: prehospital data facilitate the detection of acute heat illness in india. Western Journal of Emergency Medicine, 22(3).
    https://doi.org/10.5811/westjem.2020.11.48209
  • Weigand, K., Riediger, C., Stremmel, W., Flechtenmacher, C., & Encke, J. (2007). Are heat stroke and physical exhaustion underestimated causes of acute hepatic failure?. World Journal of Gastroenterology, 13(2), 306.
    https://doi.org/10.3748/wjg.v13.i2.306
  • Yamamoto, T., Fujita, M., Oda, Y., Todani, M., Hifumi, T., Kondo, Y., … & Tsuruta, R. (2018). Evaluation of a novel classification of heat-related illnesses: a multicentre observational study (heat stroke study 2012). International Journal of Environmental Research and Public Health, 15(9), 1962.
    https://doi.org/10.3390/ijerph15091962
  • Zheng, C., Chen, X., & Zhou, Y. (2018). Acute glutamine ingestion modulates lymphocytic responses to exhaustive exercise in the heat. Applied Physiology Nutrition and Metabolism, 43(3), 213-220.
    https://doi.org/10.1139/apnm-2017-0212


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