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.
Similar content being viewed by others
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
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
Alzeer AH, Al Otair HA (2014) Sweat chloride concentration in patients with heat stroke. J Taibah Univ Med Sci 9(1):50–53
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
Bouchama A, Knochel JP (2002) Heat stroke. N Engl J Med 346:1978–1988
Buckley IK (1972) A light and electron microscopic study of thermally injured cultured cells. Lab Investig 26:201–209
Centers for Disease Control and Prevention (CDC) (2006) Heat-related deaths—United States, 1999-2003. MMWR Morb Mortal Wkly Rep 55:796
Charkoudian N (2010) Mechanisms and modifiers of reflex induced cutaneous vasodilation and vasoconstriction in human. J Appl Physiol (1985) 109(4):1221–1228
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
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
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
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
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
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
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
Gonzalez-Alonso J, Crandall CG, Johnson JM (2008) The cardiovascular challenge of exercising in the heat. J Physiol 586:45–53
Harker J, Gibson P (1995) Heat-stroke: a review of rapid cooling techniques. Intensive Crit Care Nurs 11:198–202
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
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
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
Kenefick RW, Cheuvront SN, Sawka MN (2007) Thermoregulatory function during the marathon. Sports Med 37:312–315
Khogali M, Weiner JS (1980) Heat stroke: report on 18 cases. Lancet 2(8189):276–278
Poulton TJ, Walker RA (1987) Helicopter cooling of heatstroke victims. Aviat Space Environ Med 58(4):358–361
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
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
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
Tansey EA, Johnson CD (2015) Recent advances in thermoregulation. Adv Physiol Educ 39(3):139–148. https://doi.org/10.1152/advan.00126.2014
Weiner JS, Khogali M (1980) A physiological body-cooling unit for treatment of heat stroke. Lancet 1(8167):507–509
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
Wissler EH (2008) A quantitative assessment of skin blood flow in humans. Eur J Appl Physiol 104:145–157
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
Wissler EH (1961) Steady-state temperature distribution in man. J Appl Physiol 16:734–740
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
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
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
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00484-018-1551-1