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dc.contributor.authorAbderrezak Bouchamaen_US
dc.contributor.authorMohammed Dehbien_US
dc.contributor.authorEnrique Chaves-Carballoen_US
dc.date.accessioned2009-05-05T16:43:30Z
dc.date.available2009-05-05T16:43:30Z
dc.date.issued2007-05-12en_US
dc.identifier.citationAbderrezak Bouchama;Mohammed Dehbi;Enrique Chaves-Carballo: Cooling and hemodynamic management in heatstroke: practical recommendations. Critical Care 2007, 11(3):R54.en_US
dc.identifier.urihttp://hdl.handle.net/2271/629en_US
dc.description.abstractINTRODUCTION:Although rapid cooling and management of circulatory failure are crucial to the prevention of irreversible tissue damage and death in heatstroke, the evidence supporting the optimal cooling method and hemodynamic management has yet to be established.METHODS:A systematic review of all clinical studies published in Medline (1966 to 2006), CINAHL (Cumulative Index to Nursing & Allied Health Literature) (1982 to 2006), and Cochrane Database was performed using the OVID interface without language restriction. Search terms included heatstroke, sunstroke, and heat stress disorders.RESULTS:Fourteen articles reported populations subjected to cooling treatment for classic or exertional heatstroke and included data on cooling time, neurologic morbidity, or mortality. Five additional articles described invasive monitoring with central venous or pulmonary artery catheters. The four clinical trials and 15 observational studies covered a total of 556 patients. A careful analysis of the results obtained indicated that the cooling method based on conduction, namely immersion in iced water, was effective among young people, military personnel, and athletes with exertional heatstroke. There was no evidence to support the superiority of any one cooling technique in classic heatstroke. The effects of non-invasive, evaporative, or conductive-based cooling techniques, singly or combined, appeared to be comparable. No evidence of a specific endpoint temperature for safe cessation of cooling was found. The circulatory alterations in heatstroke were due mostly to a form of distributive shock associated with relative or absolute hypovolemia. Myocardial failure was found to be rare.CONCLUSION:A systematic review of the literature failed to identify reliable clinical data on the optimum treatment of heatstroke. Nonetheless, the findings of this study could serve as a framework for preliminary recommendations in cooling and hemodynamic management of heatstroke until more evidence-based data are generated.en_US
dc.languageenen_US
dc.language.isoen_USen_US
dc.publisherBioMedCentralen_US
dc.relation.isversionofhttp://ccforum.com/content/11/3/R54en_US
dc.relation.hasversionhttp://www.biomedcentral.com/content/pdf/cc5910.pdfen_US
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 and overen_US
dc.subject.meshDantrolene/therapeutic useen_US
dc.subject.meshHeat Stroke/physiopathology/therapyen_US
dc.subject.meshHemodynamicsen_US
dc.subject.meshHumansen_US
dc.subject.meshHydrotherapy/instrumentation/methodsen_US
dc.subject.meshHypothermia, Induced/instrumentation/methodsen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMuscle Relaxants, Central/therapeutic useen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleCooling and hemodynamic management in heatstroke: practical recommendationsen_US
dc.typeArticleen_US
dc.identifier.doi10.1186/cc5910en_US
dc.identifier.pmid17498312en_US
dc.rights.accessrightsopenAccessen_US
dc.date.captured2009-04-27en_US


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This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Except where otherwise noted, this item's license is described as: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.