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Recently, a news report about a man who fell into a vegetative state due to heat stroke has attracted widespread attention. According to reports, the man was exposed to the outdoor environment for a long time in hot weather and failed to take effective heatstroke prevention and cooling measures in time, which eventually led to severe physical discomfort and he was rushed to the hospital's intensive care unit (ICU) for treatment. His family revealed that the man has now developed symptoms of vomiting blood, incontinence, and has fallen into a vegetative state.

Heat stroke (HS) is a severe form of heat stroke, which is caused by exposure to high temperature and high humidity, resulting in a rapid increase in the body's core temperature to over 40°C, accompanied by burning skin,Impaired consciousness(such as delirium,SeizuresAccording to the cause, heat stroke can be divided into classic (non-exertional) type or exertional type.

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Exertional heat stroke is an occasional medical emergency directly related to strenuous physical activity. The main affected groups are athletes, manual laborers (such as firefighters and construction workers), and soldiers in the military. Exertional heat stroke can occur within 60 minutes of physical activity, even in lower ambient temperatures.

After a period of high-intensity training or heavy physical labor in a hot and humid environment, patients may feel general discomfort, fever, headache, dizziness, slow reaction, or sudden fainting, unconsciousness, accompanied by nausea, vomiting, shortness of breath, etc. The body temperature then rises rapidly to over 40°C, and delirium, drowsiness and coma occur. The skin becomes hot and dry, the face becomes flushed or pale, and the patient begins to sweat profusely and coldly, and then stops sweating, and suffers from tachycardia and shock.

Manifestations of organ dysfunction in exertional heat stroke include early onset of severe neurologic dysfunction characterized by agitation, delirium, and coma:

Clinical manifestations include skin ecchymosis, puncture point bleeding and ecchymosis, conjunctival hemorrhage, melena, bloody stools, hemoptysis, hematuria, myocardial hemorrhage, intracranial hemorrhage and other coagulation disorders; severe liver damage is an inherent feature of exertional heat stroke. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) increase rapidly after onset, reaching a peak on the 3rd to 4th day, and then gradually decrease, while the increase in bilirubin lags behind, usually starting to increase 24 to 72 hours after the onset of heat stroke;

Renal impairment is often associated with rhabdomyolysis, manifested as oliguria, anuria, dark urine, such as strong tea or soy sauce-colored urine; early symptoms include shortness of breath, chapped lips, andCyanosisEtc., respiratory insufficiency that can develop into acute respiratory distress syndrome (ARDS); acute gastrointestinal dysfunction that is more common with abdominal pain, diarrhea, watery stools, and gastrointestinal bleeding;

Hypovolemic shock is manifested as cardiovascular insufficiency such as hypotension, tachycardia (heart rate greater than 130 beats/minute), and arrhythmia; it is manifested as muscle soreness, stiffness, muscle weakness, tea-colored urine, soy sauce urine, and in the later stage, muscle swelling and rhabdomyolysis of compartment syndrome may occur.

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Heat stroke can be diagnosed in patients who are exposed to high temperature and high humidity environments, engage in high-intensity exercise, and have severe central nervous system dysfunction (such as coma, convulsions, mental confusion), core temperature above 40°C, increased skin temperature and/or continuous sweating, significantly increased liver transaminases, significantly decreased platelets, and quickly develop clinical manifestations such as DIC, muscle weakness, myalgia, tea-colored urine, and CK greater than 5 times the normal value.

Early and effective treatment is the key to prognosis. The key points of effective treatment mainly include rapidly lowering core temperature, blood purification, and preventing and treating DIC.

By popularizing knowledge about heat stroke, more people can realize its seriousness, take preventive measures and avoid tragedies.