Heat stroke is a potentially fatal condition marked by raised core body temperature above 40 degrees Celsius and numerous organ dysfunction/failure. It is frequently accompanied with central nervous system dysfunction, resulting in disorientation and impaired sensorium. Heat stroke causes variable involvement of other organs such as the liver, kidney, and lung, which can be fatal.
Types Of Heat Stroke
- Classic heat stroke (CHS)- CHS primarily affects the elderly, children, and those with underlying conditions, and is caused by a malfunction in thermoregulation in a high-temperature environment.
- External heat stroke (EHS)- EHS mainly occurs in military officers, soldiers and young adults who perform high-intensity physical work in a high-temperature and high-humidity environment.
Association Of Liver Injury With Heat Stroke
“Liver injury is commonly seen in association with heat stroke, however there are reports of more severe forms of liver injury such as acute liver failure in some patients with heat stroke”, said Dr Abhinav Kumar, Associate Consultant, Gastroenterology and Hepatobiliary Sciences, Fortis Escorts, Okhla Road, New Delhi.
According to Dr Kumar, organ injury in heat stroke is caused due to activation of inflammatory pathways leading to up-regulated inflammatory mediator production and activation of coagulation pathways leading to formation of clots (known as microthrombi).
Further, Dr Kumar added, “heat stroke is associated with low blood pressure which can cause decreased blood flow to the liver. A combination of these factors leads to liver injury which if severe can progress to liver failure”.
Heat stroke can be fatal and therefore it is important to avoid exposure to high temperature environments especially in elderly and sick vulnerable people. Strenuous activity in environments with high temperatures can lead to heat stroke in healthy adults too. Therefore, it is essential to be aware of the hazard of developing heat stroke and take necessary precautions to avoid the same.
Also read: Heatwave: First Aid After A Heat Stroke
Oxidative Stress
Heat stroke induces oxidative stress, overwhelming the body's antioxidant defence mechanisms. Excessive production of reactive oxygen species (ROS) can lead to liver cell damage, disrupt cellular metabolism, and impair liver function.
Vascular Complications
Heat stroke can lead to circulatory disturbances, including reduced blood flow to vital organs such as the liver. Reduced blood supply can deprive liver cells of oxygen and nutrients, leading to cellular injury and, in severe cases, liver failure.
Drug Toxicity
During heat stroke, individuals may resort to self-medication, including the use of non-steroidal anti-inflammatory drugs (NSAIDs) or other potentially hepatotoxic substances. This drug-induced liver injury, combined with the physiological stress of heat stroke, can further exacerbate liver damage.
Prevention and Awareness
Given the serious consequences of both acute liver failure and heat stroke, preventive measures and awareness are crucial.
Also read: Heat Stroke: What Is It And How To Prevent It
Hydration and Cooling
Staying well-hydrated and maintaining a cool environment are paramount in preventing heat stroke. Adequate hydration helps regulate body temperature and supports proper liver function.
Heat Safety
It is essential to recognise and mitigate environmental heat exposure, particularly during heatwaves. Avoiding strenuous activities during peak temperatures, wearing light clothing, and seeking shade or air-conditioned environments are vital in preventing heat stroke.
Education and Outreach
Healthcare professionals should educate individuals about the risks and warning signs of heat stroke and acute liver failure. Raising public awareness through community programs and campaigns can empower people to take appropriate preventive measures.