Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Mar 1;52(3):362-375.
doi: 10.1097/CCM.0000000000006170. Epub 2024 Jan 19.

Management of Heat-Related Illness and Injury in the ICU: A Concise Definitive Review

Jeffrey F Barletta  1 , Tina L Palmieri  2 , Shari A Toomey  3 , Christopher G Harrod  4 , Srinivas Murthy  5 , Heatherlee Bailey  6
Affiliations
Review

Management of Heat-Related Illness and Injury in the ICU: A Concise Definitive Review

Jeffrey F Barletta et al. Crit Care Med. .

Abstract

Objectives: The increasing frequency of extreme heat events has led to a growing number of heat-related injuries and illnesses in ICUs. The objective of this review was to summarize and critically appraise evidence for the management of heat-related illnesses and injuries for critical care multiprofessionals.

Data sources: Ovid Medline, Embase, Cochrane Clinical Trials Register, Cumulative Index to Nursing and Allied Health Literature, and ClinicalTrials.gov databases were searched from inception through August 2023 for studies reporting on heat-related injury and illness in the setting of the ICU.

Study selection: English-language systematic reviews, narrative reviews, meta-analyses, randomized clinical trials, and observational studies were prioritized for review. Bibliographies from retrieved articles were scanned for articles that may have been missed.

Data extraction: Data regarding study methodology, patient population, management strategy, and clinical outcomes were qualitatively assessed.

Data synthesis: Several risk factors and prognostic indicators for patients diagnosed with heat-related illness and injury have been identified and reported in the literature. Effective management of these patients has included various cooling methods and fluid replenishment. Drug therapy is not effective. Multiple organ dysfunction, neurologic injury, and disseminated intravascular coagulation are common complications of heat stroke and must be managed accordingly. Burn injury from contact with hot surfaces or pavement can occur, requiring careful evaluation and possible excision and grafting in severe cases.

Conclusions: The prevalence of heat-related illness and injury is increasing, and rapid initiation of appropriate therapies is necessary to optimize outcomes. Additional research is needed to identify effective methods and strategies to achieve rapid cooling, the role of immunomodulators and anticoagulant medications, the use of biomarkers to identify organ failure, and the role of artificial intelligence and precision medicine.

PubMed Disclaimer

Comment in

References

    1. O’Neill MS, Ebi KL: Temperature extremes and health: Impacts of climate variability and change in the United States. J Occup Environ Med. 2009; 51:13–25
    1. Vaidyanathan A, Malilay J, Schramm P, et al.: Heat-related deaths—United States, 2004-2018. MMWR Morb Mortal Wkly Rep. 2020; 69:729–734
    1. Dematte JE, O’Mara K, Buescher J, et al.: Near-fatal heat stroke during the 1995 heat wave in Chicago. Ann Intern Med. 1998; 129:173–181
    1. Misset B, De Jonghe B, Bastuji-Garin S, et al.: Mortality of patients with heatstroke admitted to intensive care units during the 2003 heat wave in France: A national multiple-center risk-factor study. Crit Care Med. 2006; 34:1087–1092
    1. Choudhary E, Vaidyanathan A: Heat stress illness hospitalizations—environmental public health tracking program, 20 States, 2001-2010. MMWR Surveill Summ. 2014; 63:1–10

LinkOut - more resources