Table 2.
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 |
Trect: rectal temperature.