Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management
Summary: Heatstroke is increasingly becoming a significant concern due to global warming. Systemic inflammation and coagulopathy are the two major factors that provoke life-threatening organ dysfunction in heatstroke. Dysregulated thermo-control induces cellular injury, damage-associated molecular p...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-02-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022000062 |
| _version_ | 1818975779209347072 |
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| author | Toshiaki Iba Jean Marie Connors Marcel Levi Jerrold H. Levy |
| author_facet | Toshiaki Iba Jean Marie Connors Marcel Levi Jerrold H. Levy |
| author_sort | Toshiaki Iba |
| collection | DOAJ |
| description | Summary: Heatstroke is increasingly becoming a significant concern due to global warming. Systemic inflammation and coagulopathy are the two major factors that provoke life-threatening organ dysfunction in heatstroke. Dysregulated thermo-control induces cellular injury, damage-associated molecular patterns release, hyperinflammation, and hypercoagulation with suppressed fibrinolysis to produce heatstroke-induced coagulopathy (HSIC). HSIC can progress to disseminated intravascular coagulation and multiorgan failure if severe enough. Platelet count, D-dimer, soluble thrombomodulin, and inflammation biomarkers such as interleukin-6 and histone H3 are promising markers for HSIC. In exertional heatstroke, the measurement of myoglobin is helpful to anticipate renal dysfunction. However, the optimal cutoff for each biomarker has not been determined. Except for initial cooling and hydration, effective therapy continues to be explored, and the use of antiinflammatory and anticoagulant therapies is under investigation. Despite the rapidly increasing risk, our knowledge is limited, and further study is warranted. In this review, we examine current information and what future efforts are needed to better understand and manage HSIC. |
| first_indexed | 2024-12-20T16:01:22Z |
| format | Article |
| id | doaj.art-dcb8e6551742408681e63dbf7acf0d6d |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-12-20T16:01:22Z |
| publishDate | 2022-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-dcb8e6551742408681e63dbf7acf0d6d2022-12-21T19:34:17ZengElsevierEClinicalMedicine2589-53702022-02-0144101276Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient managementToshiaki Iba0Jean Marie Connors1Marcel Levi2Jerrold H. Levy3Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo 113-8421, Japan; Corresponding author.Hematology Division Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United StatesDepartment of Medicine, University College London Hospitals NHS Foundation Trust, and Cardio-metabolic Programme-NIHR UCLH/UCL BRC London, United KingdomDepartment of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC, United StatesSummary: Heatstroke is increasingly becoming a significant concern due to global warming. Systemic inflammation and coagulopathy are the two major factors that provoke life-threatening organ dysfunction in heatstroke. Dysregulated thermo-control induces cellular injury, damage-associated molecular patterns release, hyperinflammation, and hypercoagulation with suppressed fibrinolysis to produce heatstroke-induced coagulopathy (HSIC). HSIC can progress to disseminated intravascular coagulation and multiorgan failure if severe enough. Platelet count, D-dimer, soluble thrombomodulin, and inflammation biomarkers such as interleukin-6 and histone H3 are promising markers for HSIC. In exertional heatstroke, the measurement of myoglobin is helpful to anticipate renal dysfunction. However, the optimal cutoff for each biomarker has not been determined. Except for initial cooling and hydration, effective therapy continues to be explored, and the use of antiinflammatory and anticoagulant therapies is under investigation. Despite the rapidly increasing risk, our knowledge is limited, and further study is warranted. In this review, we examine current information and what future efforts are needed to better understand and manage HSIC.http://www.sciencedirect.com/science/article/pii/S2589537022000062HeatstrokeInflammationCoagulationEndothelial cellCell death |
| spellingShingle | Toshiaki Iba Jean Marie Connors Marcel Levi Jerrold H. Levy Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management EClinicalMedicine Heatstroke Inflammation Coagulation Endothelial cell Cell death |
| title | Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management |
| title_full | Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management |
| title_fullStr | Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management |
| title_full_unstemmed | Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management |
| title_short | Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management |
| title_sort | heatstroke induced coagulopathy biomarkers mechanistic insights and patient management |
| topic | Heatstroke Inflammation Coagulation Endothelial cell Cell death |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022000062 |
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