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"Heat stroke"

Original Article

Pediatrics | Environmental

Characteristics of pediatric patients with heat-related illness transferred to emergency departments: a descriptive analysis from Japan
Yohei Okada, Marcus Eng Hock Ong, Tadashi Ishihara, Shoji Yokobori, Jun Kanda
Clin Exp Emerg Med 2025;12(4):369-379.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.343

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Characteristics of pediatric patients with heat-related illness transferred to emergency departments: a descriptive analysis from Japan
Clin Exp Emerg Med. 2025;12(4):369-379.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.343
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Characteristics of pediatric patients with heat-related illness transferred to emergency departments: a descriptive analysis from Japan
Clin Exp Emerg Med. 2025;12(4):369-379.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.343
Close
Objective
Children are particularly vulnerable to heat-related illnesses due to their unique physiological and behavioral characteristics. Understanding the epidemiology and clinical features of heat-related illnesses in children is crucial for guiding targeted preventive measures and management strategies. This descriptive study aims to investigate the characteristics of pediatric patients with heat-related illness who were transferred to emergency departments in Japan.
Methods
This study was a secondary analysis of the Heatstroke Study, led by the Heatstroke and Hypothermia Surveillance Committee of the Japanese Association for Acute Medicine. This study included pediatric patients (<18 years) with heat-related illness transferred to emergency departments in the summer from 2017 to 2021. We summarized the circumstances of onset, clinical characteristics, and outcomes.
Results
Of the 3,154 registered patients, 146 children were included. Of them, 60% were male, with a median age of 15 years (interquartile range, 13–16 years). The most cases occurred in August (47%), and most (80%) were associated with sports activities and with outdoor settings (70%). Cases with a body temperature above 40 °C were rare (3%). Most cases were admitted to hospitals (75% to the general ward and 16% to the intensive care unit), and patients admitted to intensive care unit had altered consciousness with increased serum creatinine. There were two cases of mortality, both of which were out-of-hospital cardiac arrest.
Conclusion
Most pediatric cases with heat-related illness were middle or high school students, occurred in August, and were related to outdoor sports activity. Patients admitted to hospitals suffered altered consciousness, dehydration, and acute kidney injury.

Citations

Citations to this article as recorded by  Crossref logo
  • Association of Wet-Bulb Globe Temperature with heat-related illness hospitalizations in Japan: a time-stratified, case-crossover study
    Yuka Yamamura, Takashi Hongo, Tetsuya Yumoto, Fumiya Sasai, Kohei Tokioka, Takafumi Obara, Tsuyoshi Nojima, Jun Kanda, Shoji Yokobori, Hiromichi Naito, Takashi Yorifuji, Atsunori Nakao
    International Journal of Emergency Medicine.2026;[Epub]     CrossRef
  • Superior thermotolerance in young versus adult rats undergoing heat stroke is associated with age-related differences in intestinal barrier integrity and heat shock protein responses
    Yuanhao Cai, Lei Lei, Jikuai Chen, Xi Zhao, Juelin Chen, Jiawei Zhou, Yankun Pei, Yawei Wang, Yitong Gong, Jianyao You, Yangyang Cao, Muge Song, Jun Ma, Weiyi Ma, Meng Wang, Wenjun Chang, Qing Song, Lin Zhou, Lei Li, Shuogui Xu
    Frontiers in Cell and Developmental Biology.2026;[Epub]     CrossRef
  • Day type and heatstroke-related ambulance transports in Tokyo, Japan: a time-series study
    Yuji Nishiwaki, Sachie Mori, Takehiro Michikawa
    Environmental Health and Preventive Medicine.2026; 31: 51.     CrossRef
  • 6,657 View
  • 141 Download
  • 1 Web of Science
  • 3 Crossref

Case Report

Environmental

Exertional heat stroke with reversible severe cerebral edema
Sangkil Lee, Sung-Hyun Lee
Clin Exp Emerg Med 2021;8(3):242-245.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.19.085

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Exertional heat stroke with reversible severe cerebral edema
Clin Exp Emerg Med. 2021;8(3):242-245.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.19.085
Download Citation

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Exertional heat stroke with reversible severe cerebral edema
Clin Exp Emerg Med. 2021;8(3):242-245.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.19.085
Close
Severe cerebral edema associated with exertional heat stroke is a major cause of death or disability. However, few studies on severe cerebral edema resulting from heat stroke have reported neuroradiological findings. Moreover, all the patients in these previous reports either died or remained severely disabled. Here, we report a case of exertional heat stroke with severe cerebral edema that probably developed or worsened due to delayed body temperature normalization. In contrast to previous reports, the patient showed complete clinical and neuroradiological recovery. This rare case suggests that severe cerebral edema could be reversed through meticulous supportive management. Moreover, it confirms the importance of rapid and effective cooling in heat stroke treatment.

Citations

Citations to this article as recorded by  Crossref logo
  • Dexamethasone restores blood–brain barrier integrity in an in vitro heatstroke model
    Kazuaki Okamura, Karoline Pichlerova, Takayuki Matsuo, Daisuke Watanabe, William D. Cutts, Brandon J. Kim, Yoichi Morofuji, Hideshi Okada
    PLOS One.2026; 21(6): e0352334.     CrossRef
  • Grey-to-white matter ratio on computed tomography for predicting neurological outcome in patients with heat stroke: a retrospective cohort study
    Hua Wei, Hongling Zhu, Menglong Liu, Xiaodan Zhu, Anyong Yu, Can Luo, Qingbo Zeng, Fating Zhou, Haizhen Duan
    Frontiers in Neurology.2025;[Epub]     CrossRef
  • Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) Triggered by Heat Stroke: A Case Report
    Kenko Aoki, Keisuke Suzuki, Takuya Shimada, Rei Ogawa, Kenji Dohi
    Cureus.2025;[Epub]     CrossRef
  • Ácido Tranexámico Prehospitalario versus Intrahospitalario en Trauma Mayor
    Rosa Itzel Hernández Pacheco , Hugo Alejandro Jiménez Nájera , Cristopher Alexis Lugo Farías , Lucero Joana Cortes Badillo , Anilu Calzadilla Rogel
    Estudios y Perspectivas Revista Científica y Académica .2025; 5(3): 3671.     CrossRef
  • The effect of general hyperthermia and local cooling on fentanyl tolerance in rats
    Ju. Ju. Ivnitsky, O. A. Vakunenkova, A. I. Golovko, N. V. Lapina, V. L. Rejniuk
    Extreme Medicine.2025; 27(4): 475.     CrossRef
  • Neurological disorders with general overheating of the body (scientific and literary review)
    O.V. Kravets, V.V. Yekhalov, V.A. Sedinkin, O.V. Pylypenko
    INTERNATIONAL NEUROLOGICAL JOURNAL.2024; 19(7): 202.     CrossRef
  • Surviving a classic heat stroke/hyperthermia > 42 °C – a case report
    Sonja Verena Schmidt, Jannik Hinzmann, Anna Stammler, Paula Wilhelms zu Bickern, Elisabete Macedo Santos, Marcus Lehnhardt, Christoph Wallner
    International Journal of Emergency Medicine.2024;[Epub]     CrossRef
  • Development and validation of a risk prediction model for multiple organ dysfunction syndrome secondary to severe heat stroke based on immediate assessment indicators on ICU admission
    Entong Ren, Hao Chen, Chenjiao Guo, Yuanyuan Peng, Li Tian, Lulu Yan, Huasheng Tong, Anwei Liu, Weihua Li
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • Acquired heat acclimation in rats subjected to physical exercise under environmental heat stress alleviates brain injury caused by exertional heat stroke
    Xin Li, Fan Xv, Li-zhen Ma, Ling Xing, Jin-bao Zhao, Wei-jia Zhi, Li-feng Wang, Yang Wang, Han-ding Mao, Shu-yuan Liu, Ya-hua Liu, Qing Song
    Brain Research.2023; 1811: 148393.     CrossRef
  • 8,832 View
  • 122 Download
  • 6 Web of Science
  • 9 Crossref

Original Article

Predictors of poor prognosis in patients with heat stroke
Jae-Kwon Chun, Sangchun Choi, Hyuk-Hoon Kim, Hee Won Yang, Chang Seong Kim
Clin Exp Emerg Med 2019;6(4):345-350.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.081

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Predictors of poor prognosis in patients with heat stroke
Clin Exp Emerg Med. 2019;6(4):345-350.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.081
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
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Predictors of poor prognosis in patients with heat stroke
Clin Exp Emerg Med. 2019;6(4):345-350.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.081
Close
Objective
The predictors of poor prognosis in heat stroke (HS) remain unknown. This study investigated the predictive factors of poor prognosis in patients with HS.
Methods
Data were obtained and analyzed from the health records of patients diagnosed with heat illness at Ajou university hospital between January 2008 and December 2017. Univariate and multivariate analyses were performed to identify the independent predictors of poor prognosis.
Results
Thirty-six patients (median age, 54.5 years; 33 men) were included in the study. Poor prognosis was identified in 27.8% of the study population (10 patients). The levels of S100B protein, troponin I, creatinine, alanine aminotransferase, and serum lactate were statistically significant in the univariate analysis. Multiple regression analysis revealed that poor prognosis was significantly associated with an increased S100B protein level (odds ratio, 177.37; 95% confidence interval, 2.59 to 12,143.80; P=0.016). The S100B protein cut-off level for predicting poor prognosis was 0.610 μg/L (area under the curve, 0.906; 95% confidence interval, 0.00 to 1.00), with 86% sensitivity and 86% specificity.
Conclusion
An increased S100B protein level on emergency department admission is an independent prognostic factor of poor prognosis in patients with HS. Elevation of the S100B protein level represents a potential target for specific and prompt therapies in these patients.

Citations

Citations to this article as recorded by  Crossref logo
  • Energy metabolic dysregulation in heat stroke: from mitochondrial dysfunction to multi-organ failure mechanisms and targeted intervention
    Qiqi Li, Jinquan Wang, Xiaojie Qin, Biaochao Zhong, Qiantong Wei, Chunhui Zeng, Ke Yang
    Frontiers in Pharmacology.2026;[Epub]     CrossRef
  • Cracking the code of heatstroke: new insights into diagnosis and pathological mechanisms
    Hongli Xiong, Cunhao Bian, Yue Zhao, Yu sen Wang, Bi Wei, Hao Xiao, Li Zhang, Shisheng Zhu, Jianbo Li
    International Journal of Legal Medicine.2026;[Epub]     CrossRef
  • Grey-to-white matter ratio on computed tomography for predicting neurological outcome in patients with heat stroke: a retrospective cohort study
    Hua Wei, Hongling Zhu, Menglong Liu, Xiaodan Zhu, Anyong Yu, Can Luo, Qingbo Zeng, Fating Zhou, Haizhen Duan
    Frontiers in Neurology.2025;[Epub]     CrossRef
  • Age-leukocyte-international normalized ratio score (ALIS): A bedside triparametric tool for neurological prognostication in heat stroke emergencies
    Fating Zhou, Xiaodan Zhu, Haizhen Duan, Yunfei Xiang, Siyu Yang, Wanshu Que, Rui Huang, Shanmu Ai, Yu Ma
    The American Journal of Emergency Medicine.2025; 96: 217.     CrossRef
  • Prediction of in-hospital mortality in patients with exertional heatstroke: a 13-year retrospective study
    Xinghui Wu, Jing Qian, Songbin He, Xuezhi Shi, Ronglin Chen, Huaisheng Chen, LuLu Wang, Fanfan Wang, Jiale Yang, Na Peng, Huasheng Tong
    International Journal of Environmental Health Research.2024; 34(6): 2451.     CrossRef
  • How can heatstroke damage the brain? A mini review
    Kazuhiro Yoneda, Sanae Hosomi, Hiroshi Ito, Yuki Togami, Sayaka Oda, Hisatake Matsumoto, Junya Shimazaki, Hiroshi Ogura, Jun Oda
    Frontiers in Neuroscience.2024;[Epub]     CrossRef
  • Biomarkers of heatstroke‐induced organ injury and repair
    Zachary J. Schlader, Michael S. Davis, Abderrezak Bouchama
    Experimental Physiology.2022; 107(10): 1159.     CrossRef
  • Targeted temperature management in patients with severe heatstroke
    Yoon Seok Jung, Hyuk-Hoon Kim, Hee Won Yang, Sangchun Choi
    Medicine.2020; 99(45): e23159.     CrossRef
  • 9,125 View
  • 140 Download
  • 10 Web of Science
  • 8 Crossref
Case Report
Use of an external-cooling device for the treatment of heat stroke
Byung-Chan Lee, Jung Youn Kim, Sung Hyuk Choi, Young Hoon Yoon
Clin Exp Emerg Med 2014;1(1):62-64.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.004

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Use of an external-cooling device for the treatment of heat stroke
Clin Exp Emerg Med. 2014;1(1):62-64.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.004
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
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Use of an external-cooling device for the treatment of heat stroke
Clin Exp Emerg Med. 2014;1(1):62-64.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.004
Close

Heat stroke is caused by losing control of one’s body temperature. It can be life threatening without proper treatment. In this case report, we describe a heat stroke patient treated with an external-cooling device, which is commonly used for therapeutic hypothermia after cardiac arrest. A 67-year-old woman was found unconscious with spontaneous breathing in a sauna. Her body temperature was 40.5°C when she arrived at the emergency department, and she was diagnosed with heat stroke. At seven hours after applying the Arctic Sun Temperature Management System (Medivance), her body temperature declined to 36.5°C, with neurologic improvement (Glasgow Coma Scale score increased from 3 to 12). She was admitted to an intensive care unit and discharged 14 days after admission without any neurological sequelae. In conclusion, an external-cooling device can be used effectively for heat stroke, in addition to therapeutic hypothermia after cardiac arrest.

Citations

Citations to this article as recorded by  Crossref logo
  • Severe heat stroke with multiorgan failure following collapse in a sauna
    William Jack McIver, Muhammad Zia
    BMJ Case Reports.2025; 18(1): e262069.     CrossRef
  • Extravascular Temperature Control for Heatstroke With Multi‐Organ Failure: A Survivor's Case Report
    Van Ha Thi Bich, Lich Nguyen Duc, Anh Tran Ngoc
    Clinical Case Reports.2025;[Epub]     CrossRef
  • The climate crisis in clinical practice: Addressing air pollution, heat, and microplastics
    Elizabeth Cerceo
    European Journal of Internal Medicine.2025; 139: 106435.     CrossRef
  • Full neurological recovery from severe nonexertional heat stroke with multiple organ dysfunction: A case report
    Fang Du, Jun-Wei Zheng, Yan-Bo Zhao, Kai Yang, Hu-Nian Li
    World Journal of Clinical Cases.2023; 11(10): 2355.     CrossRef
  • Association between cooling temperature and outcomes of patients with heat stroke
    Lan Chen, Shuying Xu, Xiaoling Yang, Junlu Zhao, Yuping Zhang, Xiuqin Feng
    Internal and Emergency Medicine.2023; 18(6): 1831.     CrossRef
  • Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report
    Katherine Riley Martin, Melissa Naiman, Maurice Espinoza
    Journal of Neuroscience Nursing.2020; 52(1): 9.     CrossRef
  • Clinical characteristics, prognostic factors, and outcomes of heat‐related illness (Heatstroke Study 2017–2018)
    Junya Shimazaki, Toru Hifumi, Keiki Shimizu, Yasutaka Oda, Jun Kanda, Yutaka Kondo, Shinichiro Shiraishi, Shuhei Takauji, Kei Hayashida, Takashi Moriya, Masaharu Yagi, Junko Yamaguchi, Hiroyuki Yokota, Shoji Yokobori, Masahiro Wakasugi, Arino Yaguchi, Yas
    Acute Medicine & Surgery.2020;[Epub]     CrossRef
  • Feasibility and Safety of Intravascular Temperature Management for Severe Heat Stroke: A Prospective Multicenter Pilot Study
    Shoji Yokobori, Yuichi Koido, Hajime Shishido, Toru Hifumi, Kenya Kawakita, Tomoya Okazaki, Shinichirou Shiraishi, Eiji Yamamura, Takashi Kanemura, Takanobu Otaguro, Gaku Matsumoto, Yasuhiro Kuroda, Yasufumi Miyake, Yasutaka Naoe, Kyoko Unemoto, Hiroshi K
    Critical Care Medicine.2018; 46(7): e670.     CrossRef
  • Clinical Q & A: Translating Therapeutic Temperature Management from Theory to Practice
    Mary Kay Bader, Stephen A. Figueroa, Mary McKenna Guanci, Patricia A. Blissitt, William D. Cahoon
    Therapeutic Hypothermia and Temperature Management.2017; 7(1): 61.     CrossRef
  • Multiple organ dysfunction due to heatstroke after sauna: case report and review of the literature
    Yan Zhuang, Lin-feng Dai, Ren-zheng Diao
    JRSM Open.2017;[Epub]     CrossRef
  • 15,303 View
  • 126 Download
  • 10 Web of Science
  • 10 Crossref
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CEEM : Clinical and Experimental Emergency Medicine