Rav-Acha Moshe, Hadad Eran, Epstein Yoram, Heled Yuval, Moran Daniel S
Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Israel.
Am J Med Sci. 2004 Aug;328(2):84-7. doi: 10.1097/00000441-200408000-00003.
Exertional heat stroke (EHS) is one of the most serious conditions that occur when excess heat, generated by muscular exercise, exceeds the body's heat-dissipation rate. The consequent elevated body core temperature causes damage to the body's tissues, resulting in a characteristic multiorgan syndrome, which is occasionally fatal.
We analyzed the fatal EHS cases that occurred in the Israeli Defence Forces during the last decade according to Minard's paradigm for evaluation of EHS predisposing factors, aiming to characterize the common features and unique circumstances leading to fatality.
Accumulation of predisposing factors, particularly those concerning training regulations, coupled with inappropriate treatment at site, were found to be strong predictors of a grave prognosis. Analysis of the pathologic findings of the fatal EHS cases on autopsy revealed a possible association between the duration and length of exercise prior to EHS occurrence and the extent of pathologic findings.
Strict adherence to existing training regulations may prevent further heat stroke fatalities.
劳力性热射病（EHS）是肌肉运动产生的过多热量超过人体散热速率时发生的最严重病症之一。随之升高的体核温度会对人体组织造成损害，导致一种典型的多器官综合征，偶尔会致命。
我们根据米纳德评估EHS诱发因素的范式，分析了以色列国防军在过去十年中发生的致命EHS病例，旨在确定导致死亡的共同特征和特殊情况。
诱发因素的积累，尤其是那些与训练规定有关的因素，再加上现场不恰当的治疗，被发现是严重预后的有力预测因素。对致命EHS病例尸检病理结果的分析显示，EHS发生前运动的持续时间和长度与病理结果的程度之间可能存在关联。
严格遵守现有训练规定可预防更多热射病死亡病例。
