Heat Related Issues in Cystic Fibrosis

High temperatures present an unique challenge to people with cystic fibrosis (CF).When the body is subjected to higher temperatures, it responds by producing an artificial fever. The skin appears flushed or reddish because blood surges to the skin surface. A portion of the body's water content appears on the skin surface as sweat. The body's natural way to cool itself is to sweat. Salt is a natural component of sweat, but in people with CF, the amount of salt that gets secreted is abnormally high, because individuals with CF lose 10 times more salt through sweat than the normal individual. 

Because people with CF tend to secrete high concentrations of salt in the sweat, they are prone to electrolyte imbalance, dehydration, heat exhaustion and heat stroke if precautions aren't taken. Humid conditions pose an additional risk, because the moisture content in the air can interfere with the body's ability to produce sweat droplets.

The most common heat-related illnesses are heat exhaustion, heat cramps and heat-stroke. When the body cannot cool itself, any of these conditions can occur. Patients with CF are likely to experience heat exhaustion and heat cramps when the body loses fluid, salt (also called electrolytes), and other essential nutrients. Heat related illness is also more likely to occur in people who are deficient in vitamins and minerals such as potassium and magnesium.

Preventing these complications is simple. Be sure to drink plenty of water and consume salty snack. Many people with cystic fibrosis enjoy snacking on pretzels. They are a good source of salt, complex carbohydrates, and are easily digested because they contain no fat. Sports beverages are preferable since they contain electrolytes to replace what the body loses when sweating. Bananas are also a calorie-rich snack that contains the important electrolyte, Potassium. People with cystic fibrosis are encouraged to add extra salt to their meals during hotter months. Small amounts of table salt can be added to drinking water as well to help guard against heat-related illness. People with cystic fibrosis should be careful not to overexert themselves in warmer weather. They should also avoid foods and beverages that contain caffeine,natural diuretics, and alcohol. 

Heat exhaustion is dangerous to those with CF and can happen faster than you think. 

• Heat exhaustion is one part of the spectrum of heat-related illnesses that begin with heat cramps, progresses to heat exhaustion, and finally to heat stroke.
• The body cools itself by sweating allowing that sweat to evaporate. This requires enough fluid in the body to make sweat, air circulating across the skin, and low enough air humidity to allow that sweat to evaporate.
• Causes of heat exhaustion is activity in a hot environment can overwhelm the body's ability to cool itself, causing heat-related symptoms.
• Symptoms of heat exhaustion include 
  • profuse sweating
  • weakness, 
  • nausea, 
  • vomiting, 
  • headache, 
  • lightheadedness, dizziness, confusion, irritability 
  • muscle cramps.
• Heat exhaustion can progress to heat stroke when the body's temperature regulation fails. The the person develops a change in mental status, becomes confused, lethargic and may have a seizure, the skin stops sweating, and the body temperature may exceed 106 F (41 C ). This is a life-threatening condition and emergency medical attention is needed immediately.
• Treatment for heat exhaustion includes recognizing the symptoms, stopping the activity, and moving to a cooler environment. Rehydration with water or a sports drink is the cornerstone of treatment for heat exhaustion. 
• Complications of heat exhaustion include nausea, vomiting, dehydration and muscle weakness. If the activity is not stopped and the person left in a hot environment, there can be progression of symptoms to heat stroke, a life threatening emergency.
•  Heat exhaustion can be prevented by being aware of the your environment, especially on hot, humid days.

Severe heat-stroke may lead to death. As the blood from the brain flows to other parts of the body in an attempt to cool it down, the brain is unable to carry out normal function. No longer able to cool itself through sweating, the body temperature climbs as blood pressure drops. Victims of heat-stroke may collapse and pass out, never to regain consciousness. The body's central nervous system, spinal cord, brain and vital organs can be irreparably damaged. Every year emergency rooms are flooded with people who fall victim to heat stroke.