Delayed death after uncomplicated hot tub bathing in dogs and monkeys

Gideon M. Eshel*, Peter Safar, John Sassano, S. William Stezoski

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Prolonged heat exposure as in hot tub bathing, although frequently practiced, has occasionally resulted in fatalities that have been explained by an underlying disease. We explored the tolerance of hot water immersion of 60 min in five previously healthy animals (three dogs and two monkeys). With invasive monitoring, experimental body immersion in water at 40-45°C, with core temperature kept at 40-42°C for 60 min, caused no significant cardiovascular, pulmonary or metabolic changes during hyperthermia or for 2 h after return to normothermia. Then secondary deterioration occurred with progressive hypotension, petechial hemorrhages throughout the viscera, gross gastrointestinal hemorrhages and irreversible (hypovolemic) shock. These effects occurred earlier in the monkeys than in the dogs. This shock state did not respond to standard resuscitation attempts. One dog survived the secondary shock state. We conclude that during and after hot tub immersion, good initial tolerance to heat exposure can, several hours after return of normothermia, result in delayed secondary deterioration and death. We recommend that the mechanism of this delayed shock state with apparent capillary leakage be clarified.

Original languageEnglish
Pages (from-to)189-195
Number of pages7
Issue number3
StatePublished - Jun 1998


  • Heat stress
  • Hemorrhagic diathesis
  • Hot tub bathing
  • Hyperthermia
  • Hypovolemia
  • Shock


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