[Heat stroke: a critical care perspective]

Heat stroke is a life-threatening clinical syndrome caused by an imbalance between heat production and heat dissipation resulting from exposure to a hot environment and (or) strenuous physical activity. It is characterized by a core body temperature>40 centigrade and central nervous system abnormalities (such as altered mental status, seizures, or coma), accompanied by multiple organ injury. Against the backdrop of global warming and the marked increase in extreme heat events, the incidence of heat-related illnesses has risen significantly. As the most severe form of heat-related illness, heat stroke has an abrupt onset and a critical clinical course, with high rates of severe illness and mortality, posing a serious threat to human health. The progression from mild heat-related illness to the most severe form, heat stroke, represents a continuum of progressively worsening conditions. Clinically, heat stroke presents as an acute syndrome involving complex pathophysiological processes that lead to multiple organ dysfunction. Critical illness represents a state dysregulated host response to disease or injury, ultimately resulting in multiple organ dysfunction and progression toward death. Therefore, how do heat-related illnesses evolve into the life-threatening critical state of heat stroke? This article analyzes the pathogenesis of heat stroke from a critical care perspective, aiming to deepen the understanding of heat stroke and enhance critical care-oriented clinical decision-making.