Exertional Heatstroke in Soldiers: An Analysis of Predisposing Factors, Recovery Rates and Residual Heat Intolerance.

摘要

Ten prior heat stroke patients (PH) were observed in our laboratory during a two-week protocol which measured heat acclimation ability, heat tolerance responses, fluid-electrolyte balance, thermoregulation, and blood values. Nine PH exhibited normal heat acclimation adaptations, thermoregulation, sweat gland function, whole-body sodium and potassium balance, and clinical values after exertional heatstroke. One PH (subject A) did not adapt to exercise in the heat and was defined as heat intolerant, but in a later trial (11.5 months post-heatstroke) manifested heat tolerance by virtue of successful heat acclimation. However, when evaluated by a six-hour heat tolerance test, two PH (subjects A and D) were defined heat intolerant. It was concluded that: 1) sleep loss and generalized fatigue were the most common predisposing factors for PH; 2) recovery from exertional heatstroke was idiosyncratic and may require up to one year; 3) no PH were hereditarily heat intolerant, prior to exertional heatstroke; 4) no measured variable predicted recovery from exertional heatstroke, or heat acclimation responses; 5) heat intolerance occurs in a small percentage of prior heatstroke patients, and may be transient or prolonged. Keywords: Heat acclimation; Hyperthermia; Creatinine phosphokinase; Lactic dehydrogenase; Aspartate aminotransferase; Alanine transferase. (sdw)