PubMed · 16119013
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
Tom P Moreau, Michael Deeter. 2005. Heatstroke--predictable, preventable, treatable.. https://doi.org/10.1097/01720610-200508000-00006
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Explore the source record for details and available documents.
STUDY OBJECTIVE: To evaluate the drug constitution of dantrolene by comparing reconstitution with diluent at ambient and warmed temperatures, so as to determine whether differences in reconstitution time might provide clinical or therapeutic advantages. DESIGN: Randomized study. SETTING: University-affiliated medical center. MEASUREMENTS AND MAIN RESULTS: We reconstituted 10 vials of dantrolene, 5 with room-temperature diluent (sterile water) and 5 with diluent warmed to approximately 41 degrees C. Injection of diluent (10 seconds) was followed by 5 seconds of observation and recurring 15-second cycles (10 seconds of moderate manual agitation followed by 5 seconds of observation) until full reconstitution. In a second series of reconstitutions, warmed diluent injection was immediately followed by predetermined lengths of moderate manual agitation, and reconstitution status was noted at the end of each trial. Time to full reconstitution was based on a series of predetermined objective criteria. In experiment 1, with ambient-temperature diluent (22.0 degrees C -23.1 degrees C), reconstitution occurred in 90 to 130 seconds; whereas warmed diluent (40.7 degrees C-41.3 degrees C) reconstitution occurred in less than 30 seconds (P<0.004). In experiment 2, with warmed diluent (40.9 degrees C), full reconstitution occurred after 10 seconds of injection and 18 seconds of moderate manual agitation. CONCLUSION: The use of prewarmed diluent to 41 degrees C significantly reduces dantrolene reconstitution time. Further studies should evaluate the efficacy of dantrolene reconstituted with warmed diluent.
Because they share one pathognomonic sign (major hyperthermia), classic or environmental heatstroke and malignant hyperthermia have often been confronted from the therapeutic point of view. As expected and according to major physiopathological discrepancies between both syndromes, analysis of published data does not support effectiveness of dantrolene in heatstroke despite its significant reduction in mortality in malignant hyperthermia. If cooling methods still represent the cornerstone of the heatstroke therapeutic approach, the magnitude of heat-related deaths and the morbidity associated with the August 2003 French heatwave have highlighted the need for more ambitious methods of treatment.