HEAT STROKE: CLINICAL AND CHEMICAL OBSERVATIONS ON 44 CASES 12

Abstract

Observations on 44 patients who developed heat stroke during 2 heat waves in 1936 are reported. The clinical syndrome was characterized by hyperpyrexia, absence of sweat and, in the severely affected patient, coma. The rectal temp, of the various patients ranged from 104[degree] to 112[degree] F. The majority did not present manifestations of cardiac or peripheral circulatory failure. In most instances, the attack was precipitated by cessation of sweating. Old age and the ingestion of alcoholic beverages were important predisposing causes. The following detns. were carried out on blood samples obtained during the attack, and after recovery, from a representative group of patients: plasma protein, albumin, chlorides, Na, K, Hb, red blood cell count, and vol. of packed red cells: also, O content, O saturation and CO2 content were detd. on both arterial and venous blood (femoral). There was no significant alteration in the blood electrolyte pattern. Changes in the total protein, Hb content and hematocrit indicated the presence of moderate hemoconc. The CO2 content of arterial and venous blood was low and was interpreted as indicating a moderate acidosis. The arterial O saturation and the femoral arterio-venous O difference were within normal limits in most instances. Treatment should be directed immediately toward reducing the body temp.; in those patients whose body temp, is above 106[degree] F, this can be accomplished most effectively by immersion in ice water. Circulatory failure, dehydration, or deficiency in electrolytes evidently did not appear to be important factors in the production of clinical manifestations or in effecting the failure of the sweating mechanism.