Clinical and Biochemical Characteristics of Exertional Heat Stroke among Paratroopers in Agra, India.

OBJECTIVE

The purpose of this study was to assess the clinical profile, biochemical parameters and outcome in a series of 78 patients of heat stroke admitted and treated in a military hospital in India.

METHODS

This was a prospective study in a military hospital. A total of 78 patients of exertional heat stroke admitted and treated over more than 2 years are reported. Cooling measures started immediately on site of occurrence, carried on during evacuation and in hospital, IV normal saline initiated, clinical symptoms and signs were noted. Blood was collected and sent for hematological, biochemical and coagulation parameters.

RESULTS

Clinical features noted were violent behavior( 20.51%), confusional state (58.97%),coma (29.48%), seizure (33.33%),and vomiting (26.92%).Vital parameters were recorded and laboratory parameters revealed hypophosphatemia, hyponatremia, hypokalemia along with raised transaminases, creatinine kinase and lactic dehydrogenase. Patients were managed with cooling measures, IV fluids and supportive measures. All of them survived to be discharged in a mean of 8.34 days.

CONCLUSIONS

Timely diagnosis, prompt intervention in form of effective cooling measures to reduce the temperature to acceptable levels within 30 mins, volume resuscitation, judicious use of ionotropes after adequate volume replacement and effective supportive care resulted in a favourable outcome.