Case Reports 病例報告
William Wei-Lin Pan, Thomas Tao-Min HuangExertional heat stroke (EHS) is a potentially fatal condition associated with multiorgan failure, including acute kidney and liver injury. The medical literature scarcely reports the use of the Molecular Adsorbent Recirculating System (MARS) therapy for EHS. This case report describes the successful application of MARS therapy in a 47-year-old male with EHS-induced multi-organ failure. Despite aggressive resuscitation, including intubation, mechanical ventilation, and fluid management, the patient developed complications such as metabolic acidosis, hypoxic-ischemic kidney damage, and acute liver injury. After admission to the intensive care unit, the patient required continuous kidney replacement therapy (CKRT) and MARS therapy due to progressive liver dysfunction and suspected hepatic encephalopathy. MARS therapy improved consciousness levels and stabilized the patient’s condition. However, renal function remained impaired, necessitating regular hemodialysis treatment. The patient gradually recovered kidney function and liver enzymes two months after discharge. This case report contributes to the limited literature on MARS therapy in EHS patients, emphasizing its potential role in managing this life-threatening condition. Further research is warranted to evaluate the efficacy and safety of MARS therapy in management of EHS and to investigate possible adverse events associated with MARS therapy.
潘威霖，黃道民運動性熱中暑 (Exertional Heat Stroke, EHS) 是一種可能致命的急症，與會造成多器官衰竭，包括急性腎臟和肝臟損傷。關於分子吸附再循環系統 (Molecular Adsorbent Recirculating System, MARS) 在治療EHS 的醫學文獻中報導甚少。本文報告一名 47 歲男性因 EHS 引起多器官衰竭，應用 MARS 成功治療。儘管進行了積極的復甦治療，包括插管、機械通氣和液體管理，病人仍出現代謝性酸中毒、因缺氧 - 缺血而導致急性腎和肝損傷等併發症。在送入加護病房後，病人因肝功能惡化和懷疑似肝性腦病而需要接受連續腎臟替代治療 (continuous kidney replacement therapy, CKRT) 和 MARS 治療。MARS 治療改善病人意識，穩定病情。然而，腎功能仍受損，需要定期接受血液透析治療。病人出院兩個月後，腎和肝功能逐漸恢復。本病例報告應用 MARS 成功治療 EHS 病人的經驗，為有限文獻提供額外的資訊分享，強調 MARS 在治療此種危及生命的急症中之角色。有必要進一步研究以評估 MARS 在治療 EHS 中的療效和安全性。