First aid cooling techniques for heat stroke and exertional hyperthermia: A systematic review and meta-analysis
Autor: | Matthew J. Douma, Theresa Aves, Katherine S. Allan, Jason C. Bendall, David C. Berry, Wei-Tien Chang, Jonathan Epstein, Natalie Hood, Eunice M. Singletary, David Zideman, Steve Lin, Vere Borra, Jestin N. Carlson, Pascal Cassan, Nathan P. Charlton, David S. Markenson, Daniel Meyran, Tetsuya Sakamoto, Janel M. Swain, Jeff A. Woodin |
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Rok vydání: | 2020 |
Předmět: |
Adult
Hyperthermia Fever Passive cooling Heat Stroke Heat exhaustion Poison control 030204 cardiovascular system & hematology Emergency Nursing Body Temperature law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law First Aid Humans Medicine Child Stroke business.industry 030208 emergency & critical care medicine medicine.disease Cold Temperature Anesthesia Meta-analysis Emergency Medicine Cardiology and Cardiovascular Medicine business Cohort study |
Zdroj: | Resuscitation. 148:173-190 |
ISSN: | 0300-9572 |
Popis: | Background Heat stroke is an emergent condition characterized by hyperthermia (>40 °C/>104 °F) and nervous system dysregulation. There are two primary etiologies: exertional which occurs during physical activity and non-exertional which occurs during extreme heat events without physical exertion. Left untreated, both may lead to significant morbidity, are considered a special circumstance for cardiac arrest, and cause of mortality. Methods We searched Medline, Embase, CINAHL and SPORTDiscus. We used Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods and risk of bias assessments to determine the certainty and quality of evidence. We included randomized controlled trials, non-randomized trials, cohort studies and case series of five or more patients that evaluated adults and children with non-exertional or exertional heat stroke or exertional hyperthermia, and any cooling technique applicable to first aid and prehospital settings. Outcomes included: cooling rate, mortality, neurological dysfunction, adverse effects and hospital length of stay. Results We included 63 studies, of which 37 were controlled studies, two were cohort studies and 24 were case series of heat stroke patients. Water immersion of adults with exertional hyperthermia [cold water (14–17 °C/57.2–62.6 °F), colder water (8–12 °C/48.2–53.6 °F) and ice water (1–5 °C/33.8–41 °F)] resulted in faster cooling rates when compared to passive cooling. No single water temperature range was found to be associated with a quicker core temperature reduction than another (cold, colder or ice). Conclusion Water immersion techniques (using 1–17 °C water) more effectively lowered core body temperatures when compared with passive cooling, in hyperthermic adults. The available evidence suggests water immersion can rapidly reduce core body temperature in settings where it is feasible. |
Databáze: | OpenAIRE |
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