Kido Norihiro, Tagami Takashi, Otake Kosuke, Watanabe Akihiro, Yoshino Yudai, Ishimuro Masaki, Miyakami Kazuya, Inoue Junichi
Department of Emergency and Critical Care Medicine, Nippon Medical School, Musashi Kosugi Hospital, Kanagawa, Japan.
Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.
Prehosp Emerg Care. 2024;28(7):905-909. doi: 10.1080/10903127.2024.2323575. Epub 2024 Mar 12.
Heat stroke is a life-threatening condition that is characterized by body temperatures above 40 °C and central nervous system dysfunction. Immediate cooling is imperative to prevent irreversible cellular damage and improve patient outcomes. Here, we report two cases of heat stroke that highlight the use of a novel cooling suit (CarbonCool®) as a rapid cooling intervention administered in the prehospital setting, primarily focusing on patients with classic heat stroke.
This study was a retrospective review of two cases involving older patients with severe classic heat stroke, wherein CarbonCool® was used. The device was deployed at the scene of the incidents, throughout transport, and into the emergency department setting, allowing for continuous cooling and medical intervention as needed. The effectiveness of the cooling device was assessed based on the rate of temperature reduction and overall clinical outcomes of the patients.
In both cases, CarbonCool® facilitated a rapid reduction in body temperature, aligning with the crucial requirement of immediate cooling for the management of heat stroke. The first case involved a comatose 90-year-old woman whose body temperature decreased from 42.0 to 35.8 °C within 60 min. The second case involved a comatose 70-year-old man who experienced a decrease in body temperature from 41.2 to 36.6 °C over 196 min. CarbonCool® allowed for the execution of concurrent resuscitative procedures and was compatible with various imaging modalities (including computed tomographic scan), allowing for continuous application from the scene to the intensive care unit. Moreover, both patients showed marked improvements in consciousness and were stabilized without the need for more invasive cooling procedures that are typically employed in hospital settings for such cases. Both patients were discharged without any disabilities.
We present an innovative approach to prehospital care for patients with heat stroke through the use of CarbonCool®, highlighting its efficacy for rapid cooling and its potential impact on patient outcomes. However, further studies are warranted to fully confirm the efficacy of the system.
中暑是一种危及生命的状况，其特征为体温高于40°C以及中枢神经系统功能障碍。立即降温对于防止不可逆的细胞损伤和改善患者预后至关重要。在此，我们报告两例中暑病例，重点介绍一种新型降温套装（CarbonCool®）在院前环境中作为快速降温干预措施的应用，主要针对典型中暑患者。
本研究是对两例涉及使用CarbonCool®的老年严重典型中暑患者病例的回顾性分析。该设备在事件现场、整个转运过程以及急诊科环境中使用，以便根据需要进行持续降温和医疗干预。根据体温降低速率和患者的总体临床结果评估降温设备的有效性。
在这两例病例中，CarbonCool®均促进了体温的快速降低，符合中暑管理中立即降温的关键要求。第一例病例是一名90岁昏迷女性，其体温在60分钟内从42.0°C降至35.8°C。第二例病例是一名70岁昏迷男性，其体温在196分钟内从41.2°C降至36.6°C。CarbonCool®允许同时进行复苏程序，并且与各种成像方式（包括计算机断层扫描）兼容，从而能够从现场到重症监护病房持续应用。此外，两名患者的意识均有显著改善，且病情稳定，无需采用医院环境中通常针对此类病例所使用的更具侵入性的降温程序。两名患者均康复出院，无任何残疾。
我们通过使用CarbonCool®提出了一种针对中暑患者的创新院前护理方法，突出了其快速降温的功效及其对患者预后的潜在影响。然而，需要进一步研究以充分证实该系统的疗效。
