Diagnosing and managing heat exhaustion: insights from a systematic review of cases in the desert climate of Mecca
Author:
Yezli Saber12ORCID, Yassin Yara3, Ghallab Sujoud4, Abdullah Mashan2, Abuyassin Bisher2, Vishwakarma Ramesh5, Bouchama Abderrezak2
Affiliation:
1. Biostatistics, Epidemiology and Scientific Computing Department , King Faisal Specialist Hospital and Research Centre , Riyadh , Saudi Arabia 2. Experimental Medicine Department , King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences , Riyadh , Saudi Arabia 3. Federation of Saudi Chambers Institute, Federation of Saudi Chambers , Riyadh , Saudi Arabia 4. Saudi Field Epidemiology Training Program, Assistant Agency of Preventive Health, Ministry of Health , Riyadh , Saudi Arabia 5. Norwich Clinical Trial Unit, Norwich Medical School, University of East Anglia , Norwich , UK
Abstract
Abstract
Heat exhaustion (HE) is a common, yet obscure, heat-related illness that affects millions of people yearly and its burden is projected to rise due to climate change. A comprehensive literature synthesis is lacking despite previous studies on various HE aspects. This systematic review aims to fill this gap by identifying and synthesizing available evidence on the risk factors, symptoms, biomarkers, treatment options, and outcomes for HE. The review focused on HE during the Muslim (Hajj) pilgrimage where the condition is endemic. We conducted a structured search of MEDLINE/PubMed, Embase, Web of Science Core Collection, SCOPUS, and CINAHL databases. We summarized the data from eligible studies and synthesized them in narrative form using pooled descriptive statistics. Ten studies were included between 1980 and 2019, reporting over 1,194 HE cases. HE cases presented with elevated core temperature (up to 40°C) and mainly affected older males from the Middle East and North Africa region, with overweight individuals at a higher risk. Clinical symptoms included hyperventilation, fatigue, dizziness, headaches, nausea, and vomiting, but not central nervous system disturbances. HE was associated with cardiac stress, and with water, electrolyte, and acid-base alterations. Cooling and hydration therapy were the primary management strategies, leading to a low mortality rate (pooled case fatality rate=0.11 % [95 % CI: 0.01, 0.3]). Most cases recovered within a few hours without complications. HE is associated with cardiac stress and changes in homeostasis, leading to distinct clinical symptoms. Early diagnosis and treatment of HE are crucial in reducing the risk of complications and mortality. The review provides insights into the pathophysiology and outcomes of HE, adding to the scarce literature on the subject. Prospero registration number: CRD42022325759.
Publisher
Walter de Gruyter GmbH
Subject
Public Health, Environmental and Occupational Health,Pollution,Health (social science)
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