Heat stroke laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
The laboratory finding scene in patients with a heat stroke include [[hypophosphatemia]], [[hypokalemia]], [[hypoglycemia], tension of arterial carbon dioxide is usually less than 20 mm Hg. Respiratory alkalosis is seen in non-exertional heat stroke where as lactic acidosis and respiratory alkalosis in exertional heat stroke.<ref name="pmid6893120">{{cite journal| author=Kim RC, Collins GH, Cho C, Ichikawa K, Givelber H| title=Heat stroke. Report of three fatal cases with emphasis on findings in skeletal muscle. | journal=Arch Pathol Lab Med | year= 1980 | volume= 104 | issue= 7 | pages= 345-9 | pmid=6893120 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6893120 }} </ref> | The laboratory finding scene in patients with a heat stroke include [[hypophosphatemia]], [[hypokalemia]], [[hypoglycemia]], tension of arterial carbon dioxide is usually less than 20 mm Hg. [[Respiratory alkalosis]] is seen in non-exertional heat stroke where as [[lactic acidosis]] and [[respiratory alkalosis]] in exertional heat stroke.<ref name="pmid6893120">{{cite journal| author=Kim RC, Collins GH, Cho C, Ichikawa K, Givelber H| title=Heat stroke. Report of three fatal cases with emphasis on findings in skeletal muscle. | journal=Arch Pathol Lab Med | year= 1980 | volume= 104 | issue= 7 | pages= 345-9 | pmid=6893120 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6893120 }} </ref> | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
The following laboratory findings may be noticed in a patient with heat stroke:<ref name="pmid6893120">{{cite journal| author=Kim RC, Collins GH, Cho C, Ichikawa K, Givelber H| title=Heat stroke. Report of three fatal cases with emphasis on findings in skeletal muscle. | journal=Arch Pathol Lab Med | year= 1980 | volume= 104 | issue= 7 | pages= 345-9 | pmid=6893120 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6893120 }} </ref><ref name="pmid25880507">{{cite journal| author=Leon LR, Bouchama A| title=Heat stroke. | journal=Compr Physiol | year= 2015 | volume= 5 | issue= 2 | pages= 611-47 | pmid=25880507 | doi=10.1002/cphy.c140017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25880507 }} </ref><ref name="pmid7663007">{{cite journal| author=Macario AJ| title=Heat-shock proteins and molecular chaperones: implications for pathogenesis, diagnostics, and therapeutics. | journal=Int J Clin Lab Res | year= 1995 | volume= 25 | issue= 2 | pages= 59-70 | pmid=7663007 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7663007 }} </ref> | The following laboratory findings may be noticed in a patient with heat stroke:<ref name="pmid6893120">{{cite journal| author=Kim RC, Collins GH, Cho C, Ichikawa K, Givelber H| title=Heat stroke. Report of three fatal cases with emphasis on findings in skeletal muscle. | journal=Arch Pathol Lab Med | year= 1980 | volume= 104 | issue= 7 | pages= 345-9 | pmid=6893120 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6893120 }} </ref><ref name="pmid25880507">{{cite journal| author=Leon LR, Bouchama A| title=Heat stroke. | journal=Compr Physiol | year= 2015 | volume= 5 | issue= 2 | pages= 611-47 | pmid=25880507 | doi=10.1002/cphy.c140017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25880507 }} </ref><ref name="pmid7663007">{{cite journal| author=Macario AJ| title=Heat-shock proteins and molecular chaperones: implications for pathogenesis, diagnostics, and therapeutics. | journal=Int J Clin Lab Res | year= 1995 | volume= 25 | issue= 2 | pages= 59-70 | pmid=7663007 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7663007 }} </ref> | ||
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{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | |||
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Characteristic | |||
!align="center" style="background:#4479BA; color: #FFFFFF;" |Exertional Heat Stroke | |||
!align="center" style="background:#4479BA; color: #FFFFFF;" |Classic Heat Stroke | |||
|- | |||
| rowspan="7" align="center" style="background:#DCDCDC;"|Laboratory findings | |||
|align="center" style="background:#DCDCDC;"|Acid-base disturbance | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Metabolic acidosis]] | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Mixed [[Metabolic Acidosis|metabolic]] and [[respiratory acidosis]] | |||
|- | |||
|align="center" style="background:#DCDCDC;"|[[Calcium]] | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓ | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl | |||
|- | |||
|align="center" style="background:#DCDCDC;"|[[Potassium]] | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓ or ↑ | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl | |||
|- | |||
|align="center" style="background:#DCDCDC;"|[[Phosphate]] | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑ | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓ | |||
|- | |||
|align="center" style="background:#DCDCDC;"|[[Blood glucose]] | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓ | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑ | |||
|- | |||
|align="center" style="background:#DCDCDC;"|[[Creatine kinase]] (CK) | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑↑↑ | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑ | |||
|- | |||
|align="center" style="background:#DCDCDC;"|[[Aspartate transaminase|AST]], [[Alanine transaminase|ALT]] | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑↑↑ | |||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑ | |||
|- | |||
|} | |||
|} | |||
*The tension of arterial carbon dioxide is usually less than 20 mm Hg | *The tension of arterial carbon dioxide is usually less than 20 mm Hg | ||
*Respiratory alkalosis in non-exertional heat stroke | *[[Respiratory alkalosis]] in non-exertional heat stroke | ||
*Lactic acidosis and respiratory alkalosis in exertional heat stroke | *[[Lactic acidosis]] and [[respiratory alkalosis]] in exertional heat stroke | ||
*[[Hypophosphatemia]] | *[[Hypophosphatemia]] | ||
*[[Hypokalemia]] | *[[Hypokalemia]] | ||
| Line 19: | Line 57: | ||
**[[Hyperproteinemia]] | **[[Hyperproteinemia]] | ||
*Elevated creatinine kinase | *Elevated creatinine kinase | ||
*Elevated AST and ALT | *Elevated [[AST]] and [[ALT]] | ||
===Laboratory Findings after Cooling in Exertional Heat Stroke=== | ===Laboratory Findings after Cooling in Exertional Heat Stroke=== | ||
Latest revision as of 19:35, 30 May 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
The laboratory finding scene in patients with a heat stroke include hypophosphatemia, hypokalemia, hypoglycemia, tension of arterial carbon dioxide is usually less than 20 mm Hg. Respiratory alkalosis is seen in non-exertional heat stroke where as lactic acidosis and respiratory alkalosis in exertional heat stroke.[1]
Laboratory Findings
The following laboratory findings may be noticed in a patient with heat stroke:[1][2][3]
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- The tension of arterial carbon dioxide is usually less than 20 mm Hg
- Respiratory alkalosis in non-exertional heat stroke
- Lactic acidosis and respiratory alkalosis in exertional heat stroke
- Hypophosphatemia
- Hypokalemia
- Hypoglycemia (rare finding)
- Laboratory findings secondary to hemoconcentration
- Elevated creatinine kinase
- Elevated AST and ALT
Laboratory Findings after Cooling in Exertional Heat Stroke
References
- ↑ 1.0 1.1 Kim RC, Collins GH, Cho C, Ichikawa K, Givelber H (1980). "Heat stroke. Report of three fatal cases with emphasis on findings in skeletal muscle". Arch Pathol Lab Med. 104 (7): 345–9. PMID 6893120.
- ↑ Leon LR, Bouchama A (2015). "Heat stroke". Compr Physiol. 5 (2): 611–47. doi:10.1002/cphy.c140017. PMID 25880507.
- ↑ Macario AJ (1995). "Heat-shock proteins and molecular chaperones: implications for pathogenesis, diagnostics, and therapeutics". Int J Clin Lab Res. 25 (2): 59–70. PMID 7663007.