ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ  KẾT CỤC ĐIỀU TRỊ  BỆNH NHÂN SỐC NHIỆT  TẠI BỆNH VIỆN QUÂN Y 175

Nghĩa Nguyễn Văn; Ân Vũ Đình; Kháng Diệp Hồng; Hồng Đinh Văn; Thanh Phạm Trường; Chung Nguyễn Cảnh; Bạch Tạ Văn; Sang Nguyễn Tấn

doi:10.59354/ydth175.2025.371

Keywords:

Heat stroke, Multi-organ dysfunction, Disseminated intravascular coagulation, Rhabdomyolysis

Abstract

Objective: This study aimed to describe the epidemiological, clinical, laboratory, therapeutic characteristics, and outcomes of heat stroke patients treated at Military Hospital 175 from April 2023 to August 2024 and comment on some factors affecting the outcome of treatment of heat stroke patients.

Methods: We conducted a descriptive retrospective series of 12 heat stroke cases treated at Military Hospital 175 from April 2023 to August 2024.

Results: All patients were male military personnel with a mean age of 21.25 ± 1.87 years and a mean BMI of 25.53 ± 3.67 kg/m². 83.3% enlisted for less than 3 months, and 91.7% experienced the onset of illness during April and May. The most common initial symptoms were hyperthermia (100%) and altered consciousness (100%). All patients had hyperthermia, consciousness disorders, and multi-organ dysfunction with an a mean SOFA score of 11 ± 4. Coagulopathy was present in 100% of patients, with disseminated intravascular coagulation occurring in 66.7%. Rhabdomyolysis was observed in 75% of patients, with a mean serum creatine kinase level of 2000.14 ± 2134.43 U/L. 91.7% of patients required mechanical ventilation, targeted temperature management, and continuous renal replacement therapy. 66.7% of patients underwent plasmapheresis, and one patient was treated with extracorporeal membrane oxygenation (ECMO). Four patients experienced permanent brain damage and irreversible rhabdomyolysis, confirmed by brain MRI, electroencephalogram (EEG), and electromyogram (EMG) f indings. The mortality rate in this study was 25%.

Conclusion: Heat stroke predominantly occurred during recruitment training in early summer. Onset symptoms typically include hyperthermia and altered consciousness, often accompanied by multi-organ dysfunction, coagulopathy, and rhabdomyolysis. The mortality rate remains high, with severe neurological and muscular sequelae.

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