How is hepatic injury managed in heat stroke?

Updated: Aug 02, 2019
  • Author: Robert S Helman, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Heat stroke commonly leads to severe but reversible hepatic damage. Hepatic injury is represented by elevations in transaminase levels and bilirubin. During this phase, hypoglycemia, abnormal coagulation, cerebral edema, and death can occur, although rarely.

Prolonged coagulation times also may signal the development of disseminated intravascular coagulation (DIC), which, when present, carries a poor patient prognosis. Clinical manifestations can range from abnormal laboratory values to generalized bleeding occurring approximately 48 hours after the initial insult. DIC also may predispose patients to development of acute respiratory distress syndrome (ARDS), which also increases mortality.

Treatment of hepatic failure includes the following:

  • Infusion of dextrose solutions to correct hypoglycemia

  • Early recognition and treatment of DIC, with replacement of clotting factors, fresh frozen plasma, platelets, and blood

  • Meticulous respiratory support


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