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:
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Infusion of dextrose solutions to correct hypoglycemia
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Early recognition and treatment of DIC, with replacement of clotting factors, fresh frozen plasma, platelets, and blood
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Meticulous respiratory support
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Sample display of equipment useful for noninvasive cooling techniques. Clockwise from top: ice pack and water, air-cooling blanket, Foley catheter, and intravenous fluids.
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Sample display of equipment useful for cooling via gastric lavage. Clockwise from top: ice water, nasogastric tube, endotracheal tube, and lavage bag.
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Sample display of equipment useful for cooling via peritoneal lavage. Clockwise from top: iced water, peritoneal catheter, and saline fluid.
