Adato Berliz, Dubnov-Raz Gal, Gips Hadas, Heled Yuval, Epstein Yoram
Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Israel.
The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, 52621, Israel.
Eur J Pediatr. 2016 Sep;175(9):1249-1252. doi: 10.1007/s00431-016-2751-5. Epub 2016 Jul 20.
A common and unfortunate cause for heat stroke-related deaths in children is entrapment in closed vehicles. The aim of this study was to analyze the pathological consequences of such grave events. Autopsy reports of all children that were brought to a national forensic medicine center after being found dead in closed vehicles over a 21-year period (1995-2015) were reviewed. Data extracted were the circumstances of the events, child age, sex, height and weight, time, date and duration of entrapment, and environmental temperatures at the time of entrapment and the autopsy findings. Eight deceased children were brought to the forensic medicine center for autopsy, and seven families consented to the procedure. Autopsy findings included diffuse petechiae and hemorrhages of serosal membranes (n = 7/7) and lung congestion (n = 3/7).
Typical autopsy findings following classical heat stroke in children include diffuse petechiae and hemorrhages and lung involvement. These findings are similar to those reported in adults that had died following exertional heat stroke-a very different mechanism of heat accumulation. Prevention of future events can possibly be obtained by public education on the rapid heating of closed vehicles, the vulnerability of children to heat, and the caregiver role in child entrapment.
• A common and unfortunate cause for heat stroke-related deaths in children is entrapment in closed vehicles. The pathological consequences of such grave events have not been previously reported. What is New: • This study is the first to describe autopsy findings from children who were found dead in parked cars. • Autopsy findings included diffuse petechiae hemorrhages of serosal membranes and lung congestion. • These findings are identical to those seen in adults following exertional heat stroke.
儿童中暑相关死亡的一个常见且不幸的原因是被困在封闭车辆中。本研究的目的是分析此类严重事件的病理后果。回顾了在21年期间（1995 - 2015年）被发现死于封闭车辆后被送往国家法医学中心的所有儿童的尸检报告。提取的数据包括事件情况、儿童年龄、性别、身高和体重、被困时间、日期和时长，以及被困时的环境温度和尸检结果。八名死亡儿童被送往法医学中心进行尸检，七个家庭同意了该程序。尸检结果包括浆膜弥漫性瘀点和出血（n = 7/7）以及肺充血（n = 3/7）。
儿童经典中暑后的典型尸检结果包括弥漫性瘀点、出血和肺部受累。这些发现与报道的因劳力性中暑死亡的成年人相似——这是一种非常不同的热量蓄积机制。通过对封闭车辆快速升温、儿童对热的易感性以及照顾者在儿童被困事件中的作用进行公众教育，有可能预防未来此类事件的发生。
• 儿童中暑相关死亡的一个常见且不幸的原因是被困在封闭车辆中。此前尚未报道过此类严重事件的病理后果。新发现：• 本研究首次描述了在停放车辆中发现死亡儿童的尸检结果。• 尸检结果包括浆膜弥漫性瘀点出血和肺充血。• 这些发现与劳力性中暑后成年人的发现相同。
