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Sepsis, Septic Shock, and Fatal Exertional Heat Stroke

机译:败血症,败血性休克和致命性中暑

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摘要

Exertional heat stroke (EHS) is a clinical syndrome of hyperthermia, encephalopathy, and multiorgan dysfunction that can be irreversible and fatal. While prompt recognition and immediate, aggressive total body cooling can prevent progression of the clinical syndrome, even a short delay can exacerbate the effects of hyperthermia-induced changes. EHS is linked to an inflammatory response that is akin to the systemic inflammatory response syndrome (SIRS). However because EHS is not a common problem in most hospital intensive care units and is not in the usual list of SIRS causes, it may be overlooked easily. Furthermore normalizing the body temperature of patients with EHS, especially when hyperthermia recognition and total body cooling are delayed, may not prevent SIRS and its clinical consequences. This narrative review focuses on the inflammatory response behind the pathway leading to EHS-associated organ pathology and recommends a new insight to possible clinical interventions beyond whole body cooling.
机译:过度性中暑(EHS)是高热,脑病和多器官功能障碍的临床综合征,可能是不可逆转的和致命的。尽管迅速识别并立即进行积极的全身降温可以预防临床综合征的发展,但即使短暂的延迟也可以加剧热疗诱发的变化的影响。 EHS与类似于全身性炎症反应综合征(SIRS)的炎症反应相关。但是,由于EHS在大多数医院重症监护病房中并不常见,并且不在SIRS常见原因之列,因此很容易被忽视。此外,使EHS患者的体温正常化,尤其是在热疗识别和全身降温延迟的情况下,可能无法预防SIRS及其临床后果。这篇叙述性评论着重于导致EHS相关器官病理的途径背后的炎症反应,并建议对除全身冷却外可能的临床干预措施有新的见解。

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