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Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management.

Publication ,  Journal Article
Iba, T; Connors, JM; Levi, M; Levy, JH
Published in: EClinicalMedicine
February 2022

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.

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Published In

EClinicalMedicine

DOI

EISSN

2589-5370

ISSN

2589-5370

Publication Date

February 2022

Volume

44

Start / End Page

101276

Related Subject Headings

  • 4206 Public health
  • 4203 Health services and systems
  • 3202 Clinical sciences
 

Citation

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Iba, T., Connors, J. M., Levi, M., & Levy, J. H. (2022). Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management. EClinicalMedicine, 44, 101276. https://doi.org/10.1016/j.eclinm.2022.101276
Iba, Toshiaki, Jean Marie Connors, Marcel Levi, and Jerrold H. Levy. “Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management.EClinicalMedicine 44 (February 2022): 101276. https://doi.org/10.1016/j.eclinm.2022.101276.
Iba T, Connors JM, Levi M, Levy JH. Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management. EClinicalMedicine. 2022 Feb;44:101276.
Iba, Toshiaki, et al. “Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management.EClinicalMedicine, vol. 44, Feb. 2022, p. 101276. Epmc, doi:10.1016/j.eclinm.2022.101276.
Iba T, Connors JM, Levi M, Levy JH. Heatstroke-induced coagulopathy: Biomarkers, mechanistic insights, and patient management. EClinicalMedicine. 2022 Feb;44:101276.
Journal cover image

Published In

EClinicalMedicine

DOI

EISSN

2589-5370

ISSN

2589-5370

Publication Date

February 2022

Volume

44

Start / End Page

101276

Related Subject Headings

  • 4206 Public health
  • 4203 Health services and systems
  • 3202 Clinical sciences