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Title: The efficacy of steroids in reducing morbidity and mortality from extreme hyperthermia and heatstroke – a systematic review
Authors: Walter, E
Gibson, O
Keywords: Steroids;hyperthermia;heat stress;outcomes
Issue Date: 2020
Publisher: Wiley Open Access
Citation: Pharmacology Research & Perspectives
Abstract: Severe hyperthermia from classical or exertional heatstroke, or from drug ingestion or other non-infective pyrogens, is associated with a high mortality and morbidity. A systemic pro-inflammatory response occurs during heatstroke, characterised by elevated cytokines with endotoxaemia from elevated lipopolysaccharide (LPS) levels. Corticosteroids reduce LPS and cytokine levels, suggesting that they may improve outcome. A systematic review searching Embase, MEDLINE and PubMed from the earliest date available until September 2019 was conducted, according to the PRISMA guidelines, with five papers identified. In four studies, systemic steroids administered before or at the onset of heat stress improved mortality or reduced organ dysfunction. Survival time was greatest when steroid administration preceded heat stress. In one study, a non-significant increase in mortality was seen. A dose response was observed, with higher doses extending survival time. Animal studies suggest that steroids improve mortality and/or organ dysfunction after an episode of heat stress or extreme hyperthermia.
ISSN: 2052-1707
Appears in Collections:Dept of Life Sciences Research Papers

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