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首页> 外文期刊>The Internet Journal of Emergency and Intensive Care Medicine >Heat Stroke and Cocaine in an inner-city New York hospital
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Heat Stroke and Cocaine in an inner-city New York hospital

机译：纽约市中心一家医院中暑和可卡因

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Background: The 2006 summer heat wave killed or contributed to the death of about 40 people in New York City. Methods: A retrospective review of patients admitted with heat stroke during the summer of 2006 and the association with toxic drugs. Results: Four patients were admitted with heat stroke. All of them had a temperature of more than 40 °C. Three of the patients were admitted with respiratory failure and were found to have used cocaine. Renal insufficiency, respiratory failure and rhabdomyolysis were common in our group. The Mean SAPS II score at admission was 57. All the four patients survived to hospital discharge Conclusions: The use of cocaine could decrease the threshold and predispose otherwise healthy patients during heat waves to develop heat stroke and multiorgan dysfunction. Urine toxicology and search for a toxic drug should be done routinely in patients with heat related illness presenting to the hospital. Introduction A heat wave is among the major natural events that can lead to deaths of hundreds of people within a few days or weeks (1,2,3,4,5). During the extreme heat wave in New York in August 2006, the ambient maximum daily temperature reached 102°F degrees and the minimum nocturnal temperature was in the high 90°F degrees for five consecutive days. Heat stroke claimed 40 lives in early August, the most in any heat wave since 1952. There are several reports linking heat related illness and toxic drugs, especially illicit drugs like cocaine and opioids. (2, 3) The lethal effect of cocaine is unique among other illicit drugs because it is related not only to dose but also to cocaine's propensity to cause hyperthermia. Mortality rates for cocaine overdose increase substantially in hot weather. (2, 3) The goal of our study was to evaluate all patients admitted with the diagnosis of heat stroke to the intensive care unit (ICU) and see the relationship with use of illicit drugs. Methods: This was a retrospective review of all medical records of all patients admitted to the ICU with heat stroke during the summer of 2006. Baseline characteristics of patients and their predicted ICU mortality was compared using the new simplified Simplified Acute Physiology Score II (SAPS II), which is a standardized scoring system to predict ICU mortality based on 17 variables which includes 12 physiology variables, age, type of admission (scheduled surgical, unscheduled surgical, or medical), and three underlying disease variables Heatstroke is defined as hyperthermia of >40.5°C, neurologic signs and most of the time anhidrosis, without any other causes of fever—especially infections or endocrine disorders— other than the ambient heat. Results During the summer of 2006, 468 patients were admitted to the ICU; four patients with heat stroke were identified, three males and one female. All of them had a temperature above 40 °C. Three of the patients were admitted with respiratory failure and were found to have used cocaine. Multiorgan dysfunction with renal insufficiency, respiratory failure and rhabdomyolysis were common in our group. The Mean SAPS II score at admission was 57. All the four patients survived to hospital discharge.The demographic characteristics and presentation can be seen in table 1.
机译：背景：2006年夏季热浪在纽约市造成约40人死亡或死亡。方法：回顾性分析2006年夏季中暑并与有毒药物相关的患者。结果：4例中暑。它们的温度都超过40°C。其中三名患者因呼吸衰竭而入院，被发现使用可卡因。肾功能不全，呼吸衰竭和横纹肌溶解在我们组中很常见。入院时SAPS II平均得分为57。四名患者全部幸存至出院结论：使用可卡因可以降低阈值，并在热浪中使健​​康的患者患上中暑和多器官功能障碍。在医院就诊的有热相关疾病的患者应常规进行尿毒理学检查和寻找有毒药物。引言热浪是主要的自然事件之一，可能在几天或几周内导致数百人死亡（1,2,3,4,5）。在2006年8月纽约的极端热浪期间，周围的每日最高温度连续102天达到102华氏度，最低夜间温度达到90华氏度。中风在8月初夺走40人的生命，是自1952年以来热浪最多的一年。有几篇报道将中暑相关疾病与有毒药物联系在一起，尤其是可卡因和阿片类药物等非法药物。 （2，3）可卡因的致死作用在其他非法药物中是独特的，因为它不仅与剂量有关，而且与可卡因引起体温过高的倾向有关。在炎热的天气中，过量服用可卡因的死亡率会大大增加。 （2，3）我们研究的目的是评估所有重症监护病房（ICU）确诊为中暑的患者，并了解其与使用非法药物的关系。方法：这是对2006年夏季因中暑入院的ICU所有患者的所有病历的回顾性回顾。使用新的简化的简化急性生理评分II（SAPS II）比较了患者的基线特征及其预测的ICU死亡率），这是一个基于17个变量的ICU死亡率预测的标准化评分系统，其中包括12个生理变量，年龄，入院类型（计划外科手术，非计划外科手术或医疗）以及三个基本疾病变量中暑定义为>摄氏40.5度，神经系统症状和大部分时间多汗症，除了环境热量外，没有任何其他发烧原因，尤其是感染或内分泌失调。结果2006年夏季，有468例患者被送入ICU。确定了四名中暑患者，男3例，女1例。他们所有的温度都高于40°C。其中三名患者因呼吸衰竭而入院，被发现使用可卡因。本组常见多器官功能障碍伴肾功能不全，呼吸衰竭和横纹肌溶解。入院时的SAPS II平均评分为57。四名患者均幸免了住院。其人口统计学特征和表现如表1所示。

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