Severe heat stroke with multiple organ dysfunction 英文参考文献.docVIP

Available online /content/10/2/406 Letter Severe heat stroke with multiple organ dysfunction Yuval Heled and Patricia A Deuster Human Performance Laboratory, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA Corresponding author: Yuval Heled, yheled@ Published: 21 March 2006 Critical Care 2006, 10:406 (doi:10.1186/cc4885) This article is online at /content/10/2/406 ? 2006 BioMed Central Ltd See related research by Broessner et al. in issue 9.5 [/content/9/5/R498] In a case report recently published in Critical Care, technique, because aggressive conventional cooling in the intensive care unit should achieve 39°C within 1 hour [3]. Broessner and coworkers [1] claim to have successfully treated a patient with heat stroke by using a specific cooling device. We should like to raise some important issues. Third, were NSAIDs continued during use of the CoolGard? device? If so, then it would be difficult to assess the physiologic significance and effectiveness of the cooling device. First, why were nonsteroidal anti-inflammatory drugs (NSAIDs) used acutely as a primary cooling method? No evidence supports the use of NSAIDs to reduce temperature during the acute phase of heat stroke. Moreover, they can be deleterious to the patient [2]. A rationale for the use of NSAIDs should be provided. Finally, is it not likely that an ongoing infection (in this case sinusitis) could have played some causative role with respect to the severity and complications associated with the heat illness? Although the initial computed tomographic diagnosis and physical examination did not reveal any pathology, it was later reported that computed tomography was consistent with sinusitis maxillaris and aspiration pneumonia. These infections might have had an impact on the responses and later complications, but this