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Theoretical analysis of evaporative cooling of classic heat stroke patients

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Abstract

Heat stroke is a serious health concern globally, which is associated with high mortality. Newer treatments must be designed to improve outcomes. The aim of this study is to evaluate the effect of variations in ambient temperature and wind speed on the rate of cooling in a simulated heat stroke subject using the dynamic model of Wissler. We assume that a 60-year-old 70-kg female suffers classic heat stroke after walking fully exposed to the sun for 4 h while the ambient temperature is 40 °C, relative humidity is 20%, and wind speed is 2.5 m/s−1. Her esophageal and skin temperatures are 41.9 and 40.7 °C at the time of collapse. Cooling is accomplished by misting with lukewarm water while exposed to forced airflow at a temperature of 20 to 40 °C and a velocity of 0.5 or 1 m/s−1. Skin blood flow is assumed to be either normal, one-half of normal, or twice normal. At wind speed of 0.5 m/s−1 and normal skin blood flow, the air temperature decreased from 40 to 20 °C, increased cooling, and reduced time required to reach to a desired temperature of 38 °C. This relationship was also maintained in reduced blood flow states. Increasing wind speed to 1 m/s−1 increased cooling and reduced the time to reach optimal temperature both in normal and reduced skin blood flow states. In conclusion, evaporative cooling methods provide an effective method for cooling classic heat stroke patients. The maximum heat dissipation from the simulated model of Wissler was recorded when the entire body was misted with lukewarm water and applied forced air at 1 m/s at temperature of 20 °C.

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References

  • Al-ajmia FF, Loveday DL, Bedwell KH, Havenith G (2008) Thermal insulation and clothing area factors of typical Arabian Gulf clothing ensembles for males and females: measurements using thermal manikins. Appl Ergon 39(3):407–414

    Article  Google Scholar 

  • Al-Aska AK, Abu-Aisha H, Yaqub B, Al-Harthi SS, Sallam A (1987) Simplified cooling bed for heatstroke. Lancet 1:381. https://doi.org/10.1016/S0140-6736(87)91749-1

    Article  CAS  Google Scholar 

  • Alzeer AH, Al Otair HA (2014) Sweat chloride concentration in patients with heat stroke. J Taibah Univ Med Sci 9(1):50–53

    Google Scholar 

  • Armstrong LE, Crago AE, Adams R, Roberts WO, Maresh CM (1996) Whole-body cooling of hyperthermic runners: comparison of two field therapies. Am J Emerg Med 14:355–358. https://doi.org/10.1016/S0735-6757(96)90048-0

    Article  CAS  Google Scholar 

  • Bouchama A, Knochel JP (2002) Heat stroke. N Engl J Med 346:1978–1988

    Article  CAS  Google Scholar 

  • Buckley IK (1972) A light and electron microscopic study of thermally injured cultured cells. Lab Investig 26:201–209

    CAS  Google Scholar 

  • Centers for Disease Control and Prevention (CDC) (2006) Heat-related deaths—United States, 1999-2003. MMWR Morb Mortal Wkly Rep 55:796

    Google Scholar 

  • Charkoudian N (2010) Mechanisms and modifiers of reflex induced cutaneous vasodilation and vasoconstriction in human. J Appl Physiol (1985) 109(4):1221–1228

    Article  Google Scholar 

  • Charkoudian N (2003) Skin blood flow in adult human thermoregulation: how it works, when it does not, and why. Mayo Clin Proc 78(5):603–612

    Article  Google Scholar 

  • de Dear RJ, Arens E, Hui Z, Oguro M (1997) Convective and radiative heat transfer coefficients for individual human body segments. Int J Biometeorol 40(3):141–156

    Article  Google Scholar 

  • DeFranco MJ, Baker CL 3rd, DaSilva JJ, Piasecki DP, Bach BR Jr (2008) Environmental issues for team physicians. Am J Sports Med 36(11):2226–2237

    Article  Google Scholar 

  • Dematte JE, O'Mara K, Buescher J, Whitney CG, Forsythe S, McNamee T, Adiga RB, Ndukwu IM (1998) Near-fatal heat stroke during the 1995 heat wave in Chicago. Ann Intern Med 129:173–181

    Article  CAS  Google Scholar 

  • Dhainaut JF, Claessens YE, Ginsburg C, Riou B (2004) Unprecedented heat-related deaths during the 2003 heat wave in Paris: consequences on emergency departments. Crit Care 8:1–2

    Article  Google Scholar 

  • Eshel GM, Safar P, Stezoski W (1990) Evaporative cooling as an adjunct to ice bag use after resuscitation from heat-induced arrest in a primate model. Pediatr Res 27(3):264–267

    Article  CAS  Google Scholar 

  • Gaudio FG, Grissom CK (2016) Cooling methods in heat stroke. J Emerg Med 50(4):607–616. https://doi.org/10.1016/j.jemermed.2015.09.014

    Article  Google Scholar 

  • Gonzalez-Alonso J, Crandall CG, Johnson JM (2008) The cardiovascular challenge of exercising in the heat. J Physiol 586:45–53

    Article  CAS  Google Scholar 

  • Harker J, Gibson P (1995) Heat-stroke: a review of rapid cooling techniques. Intensive Crit Care Nurs 11:198–202

    Article  CAS  Google Scholar 

  • Hee-Nee P, Rupeng M, Lee VJ, Chua WC, Seet B (2010) Treatment of exertional heat injuries with portable body cooling unit in a mass endurance event. Am J Emerg Med 28(2):246–248. https://doi.org/10.1016/j.ajem.2009.09.022

    Article  Google Scholar 

  • Hensley DW, Mark AE, Abella JR, Netscher GM, Wissler EH, Diller KR (2013) 50 years of computer simulation of the human thermoregulatory system. J Biomech Eng 135(2):021006. https://doi.org/10.1115/1.4023383

    Article  Google Scholar 

  • Kenefick RW, Cheuvront SN, Palumbo LJ, Ely BR, Sawka MN (2010) Skin temperature modifies the impact of hypohydration on aerobic performance. J Appl Physiol 109:79–86

    Article  CAS  Google Scholar 

  • Kenefick RW, Cheuvront SN, Sawka MN (2007) Thermoregulatory function during the marathon. Sports Med 37:312–315

    Article  Google Scholar 

  • Khogali M, Weiner JS (1980) Heat stroke: report on 18 cases. Lancet 2(8189):276–278

    Article  CAS  Google Scholar 

  • Poulton TJ, Walker RA (1987) Helicopter cooling of heatstroke victims. Aviat Space Environ Med 58(4):358–361

    CAS  Google Scholar 

  • Saunders AG, Dugas JP, Tucker R, Lambert MI, Noakes TD (2005) The effects of different air velocities on heat storage and body temperature in humans cycling in a hot, humid environment. Acta Physiol Scand 183(3):241–255

    Article  CAS  Google Scholar 

  • Semenza JC, Rubin CH, Falter KH, Selanikio JD, Flanders WD, Howe HL, Wilhelm JL (1996) Heat-related deaths during the July 1995 heat wave in Chicago. N Engl J Med 335:84–90. https://doi.org/10.1056/NEJM199607113350203

    Article  CAS  Google Scholar 

  • Smith JE (2005) Cooling methods used in the treatment of exertional heat illness. Br J Sports Med 39:503–507. https://doi.org/10.1136/bjsm.2004.013466

    Article  CAS  Google Scholar 

  • Tansey EA, Johnson CD (2015) Recent advances in thermoregulation. Adv Physiol Educ 39(3):139–148. https://doi.org/10.1152/advan.00126.2014

    Article  Google Scholar 

  • Weiner JS, Khogali M (1980) A physiological body-cooling unit for treatment of heat stroke. Lancet 1(8167):507–509

    Article  CAS  Google Scholar 

  • White JD, Riccobene E, Nucci R, Johnson C, Butterfield AB, Kamath R (1987) Evaporation versus iced gastric lavage treatment of heatstroke: comparative efficacy in a canine model. Crit Care Med 15(8):748–750

    Article  CAS  Google Scholar 

  • Wissler EH (2008) A quantitative assessment of skin blood flow in humans. Eur J Appl Physiol 104:145–157

    Article  Google Scholar 

  • Wissler EH, Havenith G (2009) A simple theoretical model of heat and moisture transport in multi-layer garments in cool ambient air. Eur J Appl Physiol 105(5):797–808. https://doi.org/10.1007/s00421-008-0966-5

    Article  CAS  Google Scholar 

  • Wissler EH (1961) Steady-state temperature distribution in man. J Appl Physiol 16:734–740

    Article  CAS  Google Scholar 

  • Wyndham CH, Strydom NB, Cooke HM, Maritz JS, Morrison JF, Fleming PW, Ward JS (1959) Methods of cooling subjects with hyperpyrexia. J Appl Physiol 14:771–776

    Article  CAS  Google Scholar 

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Correspondence to Abdulaziz H. Alzeer.

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Alzeer, A.H., Wissler, E.H. Theoretical analysis of evaporative cooling of classic heat stroke patients. Int J Biometeorol 62, 1567–1574 (2018). https://doi.org/10.1007/s00484-018-1551-1

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  • DOI: https://doi.org/10.1007/s00484-018-1551-1

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