Profile of Patients Admitted to ICU with Heat Related Illnesses - A Clinical Study
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 7
Abstract
Introduction: Heat-related illness (HRI) is a spectrum of disorders ranging from minor heat cramps, heat exhaustion to life-threatening heat stroke. This study was performed to assess the profile of patients admitted to ICU with features of heat related illness. Material and Methods: This retrospective study included 40 patients with heat related illnesses. In patients co-existing illness, current medications, admission vitals and Glasgow coma scale (GCS) score were recorded. Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were also recorded. Analysis of cerebrospinal fluid was performed. In few cases, echocardiography and neuroimaging was also done wherever indicated. Length of stay (LOS) in ICU, number of days on ventilator, GCS on discharge and SOFA score were recorded. Results: Out of 40 patients, 22 were males and 18 were females. Mean age of males were 45 ± 2.4 years and of females was 41±2.1 years. The difference was non - significant (P > 0.05). 15 patients had history of hypertension, 10 had type II D.M, 4 had coronary artery disease (CAD), 3 had Parkinson’s disease, 2 had dementia, 2 had hypothyroidism, 1 had seizure and 1 had rheumatoid arthritis. 10 patients had history of oral hypogycaemics, ace inhibitors (12), anti- parkinsons (3), beta blocker (8), immunosuppressant (16), anti convulsant (17) and anticholinergic (5). Mean temperature in patients was 102.2± 2.5 degree C, heart rate was 110.2± 12.4 beats/ min, MAP was 84.2± 22.1 mm/Hg, GCS was 8.13± 3.6, PaO2/FiO2 was 225.8± 103.6, APACHE II score was 19.86± 3.6, SOFA score was 7.4± 2.4, Haematocrit was 35.2± 8.4%, Total WBC was 35.2± 8.4 cells/cumm, Platelets was 2.3± 0.3 cells/cumm, INR was 1.42± 0.54, Serum creatinine was 1.4± 0.61 mg/dL, Serum bilirubin was 1.45± 1.72 mg/dL, Serum lactate was 2.3± 2.3 mmol/L, Serum sodium was 125.26± 12.3 mEq/L, Serum potassium was 3.2± 1.1 mEq/L, CPK was 1881± 2146 IU/L, ICU ALOS was 17.1± 18.12 and Ventilator days were 11.3± 15.18. Common neurological symptoms in patients were disorientation (50.3%), comatose (36%), seizures (32.45%) and drowsiness (10.15%). Conclusion: Patients with heat related illnesses had high morbidity and mortality. They had multiple organ failures. There is need to educate the people regarding symptoms and precautions that can help them preventing getting severe harmful effects.
Authors and Affiliations
Rajiv Lakhotia, Somnath Longani, Jaishree Bogra, Archana Aggarwal
Keywords
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