Who is at risk for hyperthermia?

Updated: Oct 14, 2020
  • Author: Erik D Schraga, MD; Chief Editor: Sage W Wiener, MD  more...
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Answer

Answer

Patients at risk for heat illness include the following [5, 6] :

  • Athletes exercising strenuously in hot climates

  • Elderly patients (because of decreased efficacy of thermoregulation, comorbid illness or medications, lack of fans or air conditioning, inappropriate dress)

  • Infants and small children (because of high ratio of surface area to weight, inability to control fluid intake)

  • Patients with cardiac disease or those taking beta-blockers (because of inability to increase cardiac output sufficiently for vasodilation)

  • Patients who are dehydrated because of poor fluid intake, gastroenteritis, and diuretic or alcohol use (Dehydration increases demand on ATPase pumps, which contribute 25-45% of basal metabolic rate.)

  • Patients prone to higher endogenous heat production (eg, infection, thyrotoxicosis)

  • Patients taking medications that inhibit sweat production or increase heat production (eg, anticholinergics, antidepressants, antihistamines, neuroleptics, zonisamide, sympathomimetics, alpha- and beta-blockers), especially in hot weather; deaths from cocaine are markedly increased when the ambient temperature increases [7]

Recognizing the clinical signs associated with heat illness determines the appropriate therapy, from fluid replacement for heat exhaustion to rapid aggressive cooling for heatstroke. [4, 5, 6]


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