and 6 (20%) a hypodynamic profile. The clinical response to
fluid therapy and the risk of pulmonary edema varied among
studies, thus precluding any meaningful interpretation.
In the last study, the state of hydration and response to a conservative
fluid challenge were prospectively assessed with
central venous pressure (CVP) monitoring in 34 consecutive
patients with classic heatstroke [39]. Twelve patients had a
CVP reading of zero or less on arrival, and eight of these
patients presented in shock state. Administration of an average
of 1 liter (0.5 to 2.5 liters) of crystalloids titrated to a CVP
of 3 to 8 cm H2O restored an optimal hydration state and did
not result in any signs of fluid overload.