Table 2.

Summary of data on cooling methods based on conduction in the treatment of exertional heatstroke

Study (country, year)	Population	Study design	Intervention	Outcomes measured	Results	Limitations
[18] (Israel, 1967)	Exertional heatstroke (n = 36)	Case series	Ice-filled rubber bottles over the whole body; cool air-conditioned room; target Trect: not given	Mortality; morbidity	Mortality: 22.2%; neurologic morbidity: 11.1%	Patients enrolled over 10-year period; no cooling time provided; cooling performed in different centers
[19] (U.S., 1975)	Exertional heatstroke (n = 15)	Case series	Iced water immersion; target Trect: 38.8°C	Mortality; morbidity	Mortality: 0%; neurologic morbidity: 0%	None
[20] (U.S., 1975)	Exertional heatstroke (n = 13)	Case series	Iced water immersion; target Trect: 38.3°C	Cooling time; mortality; morbidity	Cooling time: < 60 minutes, 92.3%; cooling time: > 60 minutes, 7.7%; mortality: 0%; neurologic morbidity: 0%	None
[21] (U.S., 1979)	Exertional heatstroke (n = 13)	Case series	Iced water immersion; target Trect: 38.3°C to 38.8°C	Cooling time; mortality; morbidity	Cooling time (range): 10 to 40 minutes; myocardial ischemia: 7.7%; neurologic morbidity: 0%; mortality: 0%	None
[30] (U.S., 1996)	Exertional heatstroke (n = 21)	Randomized controlled trial	Iced water immersion (1°C to 3°C) torso and upper legs (n = 14) versus wet towel and air exposure at 24.4°C (n = 7); target Trect: 38.2°C to 40.1°C	Cooling rate	Conductive-based cooling faster than evaporative (0.20 ± 0.02 versus 0.11 ± 0.02°C/minute)	Small sample size; comparability of baseline characteristics undetermined; randomization method not specified; evaporative technique suboptimal

T_rect: rectal temperature.