Rationale:

• The recommended laboratory tests are essential for the evaluation of multi-organ dysfunction characteristic of hyperthermic syndromes.
• The hepatic, renal, muscular, and coagulation systems are all heat sensitive and thus strongly influenced by heatstroke.
• Blood gases and CXR are essential for evaluation of ARDS characteristic of classic heatstroke.
• There is an empiric association between systemic infection and classic heatstroke.

Evidence:

• The elevated body temperature gives rise to a characteristic clinical and pathologic syndrome (8).
• An observational study of 58 patients who had heatstroke found a strong association between near fatal classic heatstroke and infection. Patients also had multi-organ dysfunction with neurologic impairment, moderate to severe renal insufficiency, and DIC (16).

Comments:

• The laboratory picture of heatstroke is not pathognomonic. Physicians should always consider the clinical picture in the face of the environmental conditions.