Society of Critical Care Medicine Guidelines for the Treatment of Heat Stroke
Summary
SCCM's GRADE-informed heat-stroke guideline strongly recommends active rather than passive cooling, with cold- or ice-water immersion delivering the fastest cooling when feasible. It strongly recommends against dantrolene. Both strong recommendations rely on very-low-certainty evidence; good-practice guidance discourages routine antipyretics for temperature control.
Why it matters
Begin effective physical cooling promptly in suspected heat stroke instead of relying on antipyretics or dantrolene. Adapt cooling modality to feasibility and concurrent stabilization.
Study at a glance
- Design
- Guideline
- Population
- Patients with exertional or classic heat stroke in acute and critical-care settings.
- Sample size
- Not applicable
- Intervention
- Rapid active cooling and guideline assessment of temperature-modifying medications.
- Comparator
- Passive cooling and alternative measures across guideline questions; not a single trial.
- Primary endpoint
- Guideline outcomes on cooling and clinical treatment, not a trial primary endpoint.
Key recommendations
- Strong recommendation for active rather than passive cooling (very-low-certainty evidence).
- Cold- or ice-water immersion is the fastest cooling approach when feasible.
- Strong recommendation against dantrolene (very-low-certainty evidence).
- Good-practice statement discourages routine antipyretics for heat-stroke temperature reduction.
Limitations
Evidence supporting both strong recommendations is very low certainty and immersion may not be feasible. Official SCCM recommendation material and PubMed abstract were reviewed, not the complete journal article.
Recommendation strength
Strong for active cooling and against dantrolene, both based on very-low-certainty evidence; other recommendations are good-practice statements.
Read the primary source
Full text: Official society summary available.
Original sourceDOI: 10.1097/CCM.0000000000006551
PMID: 39982186
Material reviewed: official society summary.
Source retrieved Oct 28, 2026. Official SCCM recommendations and primary PubMed abstract PMID 39982186 DOI 10.1097/CCM.0000000000006551 reviewed. Epub February 21, 2025; society page dated February 22, February 1 print. Complete journal guideline not reviewed. No verified correction found in targeted check.
Corrections & review history
No corrections recorded. Human review: not yet human-reviewed.