Objective: To investigate the nursing strategy and curative effect for two kinds of circulating fluid replacement in the treatment of heat stroke (HS) with multiple organ dysfunction (MODS). Methods: The nursing data for 32 patients with HS were analyzed retrospectively. 17 patients of group A were treated with "spend-and-tax" of circulating fluid replacement. 15 patients of group B were treated with conventional fluid replacement. The rehydration fluid was 5% glucose (500ml) and Ringer′s solution (500ml). If necessary, the potassium should be supplemented. The last, to observe the effect of "spend-and-tax" on the outcome of comprehensive treatment of HS combined with MODS. Results: 17 patients (group A) were all cured. During treatment, water, electrolyte and acid-base balance disorders did not occur. Comparing with the 15 cases (group B) treated for conventional fluid replacement at same time, the temperature (T), heart rate (HR) were significantly improved (t=-7.453-7.632, all P<0.05), the arterial blood pressures (ABP) were significantly increase (t=-7.896--3.326, all P<0.05). Conclusions Using the model of "spend-and-tax" fluid replacement can obviously improve the function of liver and kidney, reduce the injury of myocardium and skeletal muscle, improve prognosis, and decrease the mortality rate on patient suffered HS complicated MODS. It was an important content of nursing work that observing and nursing water、electrolytes for patients with HS and MODS.