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2006, Number 4

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Rev Inst Nal Enf Resp Mex 2006; 19 (4)

Pulmonary hemorrhage and acute respiratory distress syndrome secondary to heat stroke

Castillo OG, Solís C
Full text How to cite this article

Language: Spanish
References: 10
Page: 276-281
PDF size: 117.81 Kb.


Key words:

Heat stroke, rabdomyolisis, lung hemorrhage, hemoptysis, ARDS.

ABSTRACT

Heat stroke is a rare and underdiagnosed entity, it is more frequently seen in the northern states of Mexico after exposure to high environmental temperatures that induce elevation of the body temperature, triggering metabolic derangements that can result in death.
We present the case of a 24 year old immigrant from the southeast state of Chiapas found in the Desert of Altar, in the northern state of Sonora; he was semiconscious, dehydrated and in poor general condition after attempting to cross the desert in his way to the border with the USA. He was brought to our hospital with labored breathing, hemoptysis, lung infiltrates and progressive deterioration of his blood gases. He was intubated and mechanically ventilated; the initial course was characterized by increased CPK levels suggestive of rabdomyolisis, acute renal failure, disseminated intravascular coagulation, lung hemorrhage and acute respiratory distress syndrome secondary to the heat stroke. He spent 14 days in the ICU receiving 4 courses of hemodyalisis, ventilatory support, iv fluids, antibiotics and monitoring of his respiratory, renal, cardiovascular, neurologic and metabolic parameters. He was discharged 21 days after admission.
Heat stroke prevention is mandatory by public education; early diagnosis should avoid the full-blown systemic derangements; adequate support can reverse an otherwise potentially fatal course.


REFERENCES

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  5. Kunihiro A. Heat exhaustion and heatstroke 2004. eMedicine. September 17, 2004.

  6. Mackowiak PA. Fever: basic mechanisms and management. 2nd ed. Philadelphia: Lippincott-Raven;1997. p. 35-40.

  7. Hall DM, Buettner GR, Oberley LW, Xu L, Matthes RD, Gisolfi CV. Mechanisms of circulatory and intestinal barrier dysfunction during whole body hyperthermia. Am J Physiol Heart Circ Physiol 2001;280:H509-H521.

  8. Sakurada S, Hales JR. A role for gastrointestinal endotoxins in enhancement of heat tolerance by physical fitness. J Appl Physiol 1998;84:207-214.

  9. Bouchama A, Hammami MM. Endotelin-1 in heat stroke. J Appl Physiol 1995;79:1391.

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Rev Inst Nal Enf Resp Mex. 2006;19