Purpose: To describe and characterize the coagulation abnormalities associated with heat stroke patients admitted to the intensive care unit. Methods: We retrospectively collected and analyzed data on heat stroke patients admitted to 9 Chicago hospitals. The inclusion criteria were admission to the ICU between 7/12/95 and 7/20/95, mental status changes, and rectal temperature ≥40.6°C (105°F), or with environmental evidence of excessive heat exposure where the patient was found. Forty eight patients who met the criteria were found. Results: 25/45 (56%) patients developed thrombocytopenia, out of them 21/25(84%) patients had evidence of DIC with either prolonged Prothrombin Time 19/25 (76%), positive D-Dimers or FSP 12/25 (48%), or hypofibrinogenemia 8/25 (32%). GI bleeding occurred in 6/25 (24%) thrombocytopenic patients, while 5/25 (20%) thrombocytopenic patients received platelets transfusions, and 4 patients received FFP transfusions. 6/25 (24%) patients with thrombocytopenia and DIC died; while all patients with thrombocytopenia without DIC survived. In thrombocytopenic patients, the mean platelets count on admission was (132K±50K) which dropped to a nadir of (43K±24K) in an average of (2.6±1) days, and recovered usually in 4-7 days. There was no correlation between the degree of thrombocytopenia and the peak reported temperature. Conclusions: Preliminary analysis of our data indicates that thrombocytopenia in patients with heat stroke is caused by DIC in most of the patients (84%), while a subgroup (16%) of thrombocytopenic patients have no evidence of DIC. Clinical Implications: Heat stroke patients who present with thrombocytopenia and DIC have worse morbidity and mortality than thrombocytopenic patients without DIC. The cause of thrombocytopenia in the latter group could be due to direct bone marrow suppression.
|Original language||English (US)|
|Issue number||4 SUPPL.|
|State||Published - Oct 1 1996|
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine