Abstract
Exertional heatstroke (EHS) is a life-threatening disease characterized clinically by central nervous system dysfunction and severe hyperthermia. It frequently occurs among athletes, soldiers, and laborers. While cardiopulmonary symptoms are common in patients undergoing EHS, irreversible acute liver failure is a rarely described phenomenon. When managing cases of EHS complicated by acute liver failure, it is crucial to act promptly with aggressive total body cooling in order to prevent progression of the clinical syndrome. However, an urgent liver transplantation can be a therapeutic strategy when patients fail to improve with supportive measures.
Highlights
Heatstroke (HS) is usually characterized by severe elevation of the core body temperature and central nervous system dysfunction [1,2]
HS is a serious clinicopathologic entity that can lead to multiple organ failures
Sufficient intravascular volume maintenance is recommended in the management of acute liver failure (ALF)
Summary
Heatstroke (HS) is usually characterized by severe elevation of the core body temperature (above 40°C, 104°F) and central nervous system dysfunction [1,2]. Initial vital examination revealed a blood pressure of 128/63 mmHg, respiratory rate of 28, heart rate at 131 beats/min, core body temperature of 42.2°C (108°F), and oxygen saturation of 95% on room air. On examination, he was only responsive to noxious stimulus. After 24 hours, blood started oozing from his intravenous access site, and the patient developed disseminated intravenous coagulation (DIC) His platelet level dropped to 26 x 109/L(normal: 150-450 x 109/L), international normalized ratio (INR) increased to 8.3 (normal: 0.8 to 1.2), and plasma fibrinogen decreased to 75 mg/dL (normal: 150-400 mg/dL). He is 12-months postoperative and continues to do well
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