Clinical characteristics of heat stroke-induced shock

Wan Xiaolei; Song Jingchun; Yu Yongchun; Zeng Junjie; Song Xiaomin; Xu Mimi; Peng Enlan

doi:10.3969/j.issn.1002-1949.2024.06.009

Abstract：Objective To investigate the clinical characteristics of heat stroke-induced shock.Methods A retrospective analysis was conducted on the clinical data of 17 patients with heat stroke-induced shock and 18 patients with septic shock admitted to the Department of Critical Care Medicine of No.908th Hospital of Joint Logistics Support Force of Chinese PLA from June 2019 to February 2024.At admission,complete blood count,blood biochemistry,coagulation profile,thromboelastography(TEG),and hemodynamic parameters including mean arterial pressure(MAP),cardiac index(CI),global end-diastolic volume index(GEDVI),peripheral vascular resistance index(SVRI),as well as extravascular lung water index(ELWI)were collected for statistical analysis.Kaplan-Meier survival analysis was performed to compare 14 d survival rate between two groups.Results There were no significant differences in MAP,cardiae index,GEDVI and SVRI between the heat stroke-induced shock group and the septic shock group(P＞0.05).However,the heat stroke-induced shock group had significantly lower ELWI[7.00(6.00-9.00)mL/kg vs.12.00(8.00-16.00)mL/kg],fibrinogen[1.80(1.42,2.41)g/L vs.2.97(2.49,4.63)g/L],Glasgow coma scale[3.00(3.00,4.00)vs.12.00(8.25,13.25)],and TEG-MA[(44.18±10.01)mm vs.(57.71±10.92)mm],the significantly longer thrombin time[19.7(17.3,22.2)s vs.16.2(15.1,18.5)s]and TEG-K[5.10(2.50,6.65)min vs.2.65(1.48,3.90)min],and the significantly higher creatine kinase[2 559(555,3 845)U/L vs.316(128,864)U/L],compared with the septic shock group(all P＜0.05).Conclusions Both heat stroke-induced shock and septic shock present with hyperdynamic circulation,but heat stroke-induced shock is characterized by more severe coagulopathy,central nervous system impairment,and rhabdomyolysis.