Heat-Related Illnesses in India: Focus on Fluid-Electrolyte Management

Heat exhaustion represents a growing clinical and public health challenge, driven by escalating environmental heat exposure. Disturbances in body fluid homeostasis and electrolyte balance play a central role in its development, often resulting from prolonged heat stress and insufficient fluid replenishment. This narrative review synthesizes current evidence on the underlying mechanisms, symptom spectrum, and contemporary management approaches, with particular emphasis on hydration-based interventions. The clinical profile spans early nonspecific symptoms to more pronounced physiological compromise, underscoring the importance of timely identification and intervention to prevent deterioration. Management priorities include reducing thermal load alongside restoring circulatory volume and electrolyte equilibrium. Oral rehydration remains a cornerstone for mild-to-moderate presentations, with fluid composition influencing rehydration efficiency. In this context, electrolyte-balanced formulations have gained attention for their ability to support rapid fluid uptake and physiological stability. Recent developments highlight the role of ready-to-drink (RTD) hydration drinks as practical alternatives to conventional preparations. RTD formulations provide a pre-formulated combination of fluids and electrolytes in a ready-to-consume format, without the need for preparation or dilution. These offer advantages in consistency, ease of use, and acceptability, which may enhance adherence in real-world settings. Tailored strategies are particularly important for populations with heightened vulnerability to fluid imbalance, including older adults and individuals with comorbid conditions. Therefore, rehydration options, including RTD formulations, may provide a promising hydration-focused approach to mitigate heat exhaustion and improve clinical outcomes across diverse environmental and healthcare settings.