We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

The Metabolic and Respiratory Alterations of Heat Stroke

Charles L. Sprung, MD; Carlos J. Portocarrero, MD; Antoine V. Fernaine, MD; Peter F. Weinberg, MD
Arch Intern Med. 1980;140(5):665-669. doi:10.1001/archinte.1980.00330170081028.
Text Size: A A A
Published online


• The metabolic and respiratory changes of 21 patients with heat stroke were studied. Admission arterial blood gas levels were measured, and serum bicarbonate, lactate, calcium, phosphorus, and anion gap determinations were performed. Seven patients had a metabolic acidosis (pH 7.20 ± 0.04, Pco2 32 ± 2 mm Hg, and bicarbonate 12 ± 1 mEq/L), seven a combined metabolic acidosis and respiratory alkalosis (pH 7.39 ± 0.01, Pco2 25 ± 1 mm Hg, and bicarbonate 15 ± 1 mEq/L), four a respiratory alkalosis (pH 7.45 ± 0.01, Pco2 30 ± 1 mm Hg, and bicarbonate 20 ± 1 mEq/L), one a metabolic and respiratory acidosis (pH 7.13, Pco2 52 mm Hg, and bicarbonate 17 mEq/L), and one a respiratory acidosis (pH 7.30, Pco2 56 mm Hg, and bicarbonate 27 mEq/L). The 15 patients with a metabolic acidosis had a pH of 7.28 ± 0.03, Pco2 of 30 ± 2 mm Hg, bicarbonate level of 14 ± 1 mEq/L, lactate concentration of 6.5 ± 1.0 mEq/ L, and an anion gap of 26 ± 4 mEq/L. Nine patients were hypocalcemic (7.8 ± 0.3 mg/dL), and five patients were hypophosphatemic (2.0 ± 0.2 mg/dL). The predominant metabolic change in heat stroke is a metabolic acidosis secondary to increased lactate content and/or a respiratory alkalosis. Hypocalcemia is common and hypophosphatemia is not infrequent.

(Arch Intern Med 140:665-669, 1980)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.