The combination of extreme heat, humidity and strenuous exercise is potentially challenging to the thermoregulatory system of a Thoroughbred racehorse, and under certain circumstances can cause a condition called exertional heat illness (EHI). It is difficult to predict its occurrence in an individual animal due to the combination on race day of extrinsic and intrinsic risk factors. Education regarding EHI is essential to its prevention, and lack of understanding amongst those responsible for the horse’s care may in fact be the most important risk factor. The pathophysiology of EHI is similar across elite athletic species and is directly related to an elevation in core body temperature that exceeds the ‘critical thermal maximum’, causing widespread destruction of cells. It is not only the high core temperature but also its duration that will dictate outcome. Treatment strategies should decrease the hyperthermia to near normal levels within 30 min of onset, which will minimise adverse consequences. This review article outlines the pathophysiological changes as EHI progresses, and the case definition at each emergent level. Pharmacological treatment strategies and their rationale are presented. Aggressive cooling, however, is the key treatment and requires a technique which is both practical and effective in rapidly reducing core body temperature. The treatment paradigm is early detection, rapid assessment enabling prioritisation of individuals and aggressive cooling. Each stage is critically discussed.

中文翻译：

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纯种赛马的劳累性热病——病理生理学、病例定义和治疗原理

极端高温、潮湿和剧烈运动的结合对纯种赛马的体温调节系统具有潜在的挑战，并且在某些情况下会导致一种称为劳累性热病 (EHI) 的疾病。由于外在和内在风险因素的组合，很难预测其在个体动物中的发生。关于 EHI 的教育对其预防至关重要，负责马匹护理的人员缺乏了解实际上可能是最重要的风险因素。EHI 的病理生理学在精英运动物种中是相似的，并且直接与核心体温升高超过“临界热最大值”相关，从而导致细胞的广泛破坏。决定结果的不仅是高核心温度，还有它的持续时间。治疗策略应在发病后 30 分钟内将热疗降低至接近正常水平，这将最大限度地减少不良后果。这篇综述文章概述了随着 EHI 进展的病理生理变化，以及每个紧急级别的病例定义。介绍了药物治疗策略及其基本原理。然而，积极的冷却是关键的治疗方法，需要一种既实用又有效的快速降低核心体温的技术。治疗范式是早期发现、快速评估，能够优先考虑个体和积极降温。每个阶段都进行了批判性讨论。这将最大限度地减少不利后果。这篇综述文章概述了随着 EHI 进展的病理生理变化，以及每个紧急级别的病例定义。介绍了药物治疗策略及其基本原理。然而，积极的冷却是关键的治疗方法，需要一种既实用又有效的快速降低核心体温的技术。治疗范式是早期发现、快速评估，能够优先考虑个体和积极降温。每个阶段都进行了批判性讨论。这将最大限度地减少不利后果。这篇综述文章概述了随着 EHI 进展的病理生理变化，以及每个紧急级别的病例定义。介绍了药物治疗策略及其基本原理。然而，积极的冷却是关键的治疗方法，需要一种既实用又有效的快速降低核心体温的技术。治疗范式是早期发现、快速评估，能够优先考虑个体和积极降温。每个阶段都进行了批判性讨论。是关键的治疗方法，需要一种既实用又有效的快速降低核心体温的技术。治疗范式是早期发现、快速评估，能够优先考虑个体和积极降温。每个阶段都进行了批判性讨论。是关键的治疗方法，需要一种既实用又有效的快速降低核心体温的技术。治疗范式是早期发现、快速评估，能够优先考虑个体和积极降温。每个阶段都进行了批判性讨论。