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Review
. 2025 Jul 15:13:1596039.
doi: 10.3389/fcell.2025.1596039. eCollection 2025.

Advances in the comprehensive mechanisms, diagnosis, and treatment of heatstroke-induced coagulopathy

Chuhan Xiang #  1   2   3 , Ling Gao #  4   5 , Xuhui Liu #  6 , Jun Xiang  1   2 , Bin Zhu  4   5 , Shihui Fu  7   8 , Jianhui Zhao  3   9 , Qing Song  3   9
Affiliations
Review

Advances in the comprehensive mechanisms, diagnosis, and treatment of heatstroke-induced coagulopathy

Chuhan Xiang et al. Front Cell Dev Biol. .

Abstract

Heatstroke (HS) is a life-threatening condition that is precipitated by heat stress. The coagulation disorder that consequentially develops is termed heatstroke-induced coagulopathy (HIC). HIC typically presents as either hypocoagulopathy or hypercoagulopathy and is a principal complication that contributes to HS-associated mortality. There is no current consensus regarding HIC pathophysiology and specific pharmacological treatments. We review the diagnostic approaches, underlying mechanisms, and therapeutic interventions for HIC, with a particular emphasis on pharmacological treatments that include replacement therapy, anticoagulant therapy, traditional Chinese medicine, and novel therapies. The aim of this study is to enhance HIC awareness among clinicians and researchers and discuss the latest treatment strategy advancements to ultimately facilitate comprehensive HIC management and reduce its mortality rate.

Keywords: anticoagulation; diagnostic criteria; heatstroke; heatstroke-induced coagulopathy; pathogenesis; substitute.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Mechanisms of heatstroke-induced coagulopathy occurrence. Notes: DAMPs: damage-associated molecular patterns, NETs: Neutrophil extracellular traps, TF: tissue factor, PAR-1: protease-activated receptor-1, t-PA: tissue-type plasminogen activator, PAI-1: plasminogen activator inhibitor-1, vWF: von Willebrand factor, HIC: heatstroke-induced coagulopathy.
FIGURE 2
FIGURE 2
Mechanisms of replacement and anticoagulation therapy for heatstroke-induced coagulopathy. Notes: vWF: von Willebrand factor. APC: Activated protein C.
FIGURE 3
FIGURE 3
Comprehensive treatment of heatstroke-induced coagulopathy.
See this image and copyright information in PMC

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