Some of the complications associated with heatstroke occur early as opposed to late (Table 18.7.15). In patients with a relatively intact cardiovascular system, heat stress causes an increase in heart rate and cardiac index. Most heatstroke victims have a high cardiac index, elevated central venous pressure, and a low peripheral resistance. However, heart failure, pulmonary edema, and cardiovascular collapse can occur even in young healthy individuals. In any age group, the presence of hypotension, decreased cardiac output, and a falling cardiac index indicates a particularly poor prognosis. A pulmonary artery catheter may be necessary in the assessment of appropriate volume replacement.
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