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Does Gender Affect Rectal Temperature Cooling Rates? A Critically Appraised Topic.

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    Exertional heat stroke (EHS) treatment using cold-water immersion (CWI) shows hyperthermic females cool approximately 33% faster than males. This difference is likely due to body composition, but CWI remains effective for all EHS patients.

    Keywords:
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    Area of Science:

    • Sports Medicine
    • Environmental Physiology
    • Emergency Medicine

    Background:

    • Exertional heat stroke (EHS) is a critical medical emergency requiring rapid cooling.
    • Current EHS treatment guidelines, particularly cold-water immersion (CWI), are often based on male-only research.
    • Physiological differences between genders may influence CWI efficacy.

    Purpose of the Study:

    • To investigate whether rectal temperature (Trec) cooling rates during CWI differ between hyperthermic males and females.
    • To determine if existing EHS cooling recommendations are gender-specific.

    Main Methods:

    • A systematic review and meta-analysis of studies comparing CWI cooling rates in hyperthermic males and females.
    • Extraction of Trec cooling rates from relevant research.

    Main Results:

    • The average Trec cooling rate for males was 0.18°C/min, while for females it was 0.24°C/min.
    • Hyperthermic females demonstrated a significantly faster cooling rate (approximately 33% faster) compared to males.
    • Both genders achieved cooling rates exceeding the recommended >0.15°C/min for EHS.

    Conclusions:

    • Hyperthermic females exhibit faster cooling rates with CWI than males, potentially due to higher body surface area-to-mass ratios and lower lean body mass.
    • CWI is a highly effective method for lowering Trec in EHS patients, irrespective of gender.
    • Clinicians should be prepared to administer CWI to all EHS victims, recognizing its high survival rate when applied correctly.