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Acid-base alterations in heatstroke.

A Bouchama1, E B De Vol

  • 1Department of Medicine (MBC 46), King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia. abouchama@hotmail.com

Intensive Care Medicine
|June 12, 2001
PubMed
Summary
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Metabolic acidosis is the primary acid-base disturbance in heatstroke patients, increasing with hyperthermia severity. This finding is crucial for understanding heatstroke pathophysiology and management.

Area of Science:

  • Environmental Medicine
  • Critical Care Medicine
  • Physiology

Background:

  • Heatstroke is a severe condition characterized by elevated body temperature.
  • Acid-base balance is critical for physiological function.
  • Understanding metabolic changes in heatstroke is essential for patient outcomes.

Purpose of the Study:

  • To investigate the acid-base balance in patients experiencing heatstroke.
  • To determine the prevalence and characteristics of acid-base disturbances during heatstroke.

Main Methods:

  • Retrospective analysis of 109 heatstroke patients in Makkah, Saudi Arabia.
  • Prospective collection and analysis of arterial blood gases.
  • Assessment of heatstroke severity using Simplified Acute Physiology Score and Organ System Failure score.

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Main Results:

  • Metabolic acidosis was observed in 81% of patients, often with a large anion gap.
  • Respiratory alkalosis occurred in 55% of patients.
  • Metabolic acidosis prevalence significantly correlated with higher rectal temperatures (p < 0.0001).

Conclusions:

  • Metabolic acidosis is the predominant acid-base alteration in heatstroke.
  • Despite metabolic acidosis, neurologic morbidity and mortality were not significantly different between groups.