The importance of brain temperature in patients after severe head injury: Relationship to intracranial pressure, cerebral perfusion pressure, cerebral blood flow, and outcome
The importance of brain temperature in patients after severe head injury: Relationship to intracranial pressure, cerebral perfusion pressure, cerebral blood flow, and outcome
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DOI：
10.1089/089771502753754046
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发表时间：
2002-05-01
影响因子：
4.2
通讯作者：
Bullock, R
中科院分区：
文献类型：
--
作者：
Soukup, J;Zauner, A;Bullock, R
连续测量58例重型颅脑损伤患者的脑温度，并与直肠温度、颅内压、脑血流量和3个月后的结局进行比较。还计算了脑和直肠温度之间的温差。当其他方法失败时，轻度低温（34- 36 ℃）也用于治疗无法控制的颅内压（ICP）超过20 mm Hg。脑温和直肠温有很强的相关性（r = 0.866; p < 0.001）。确定了四个群体。平均脑温范围为常温组36.9 ± 0.4 ℃，高温组38.2 ± 0.5 ℃，轻度治疗性低温组35.3 ± 0.5 ℃，无主动冷却的低温组34.3 ± 1.5 ℃。对于T-br高于36.0 ℃（0.0 +/-0.5 ℃）的患者，平均DeltaT（br-rect）为阳性，而对于轻度治疗性低温（-0.2 +/-0.6 ℃）的患者，以及脑温低于36 ℃但无主动冷却（0.8 +/-1.4 ℃）的患者（自发性低温组），平均DeltaT（br-rect）为阴性。与常温和高温组相比，主动降温组脑灌注压（CPP）显著升高。脑温在36.0 ℃和37.5 ℃之间的患者的平均脑血流量（CBF）为37.8 +/- 14.0 mL/100 g/min。
Brain temperature was continuously measured in 58 patients after severe head injury and compared to rectal temperature, intracranial pressure, cerebral blood flow, and outcome after 3 months. The temperature difference between brain and rectal temperature was also calculated. Mild hypothermia (34-36degreesC) was also used to treat uncontrollable intracranial pressure (ICP) above 20 mm Hg when other methods failed. Brain and rectal temperature were strongly correlated (r = 0.866; p < 0.001). Four groups were identified. The mean brain temperature ranged from 36.9 +/- 0.4degreesC in the normothermic group to 38.2 +/- 0.5degreesC in the hyperthermic group, 35.3 +/- 0.5degreesC in the mild therapeutic hypothermia group, and 34.3 +/- 1.5degreesC in the hypothermia group without active cooling. The mean DeltaT(br-rect) was positive for patients with a T-br above 36.0degreesC (0.0 +/- 0.5degreesC) and negative for patients during mild therapeutic hypothermia (-0.2 +/- 0.6degreesC) and also in those with a brain temperature below 36degreesC without active cooling (0.8 +/- -1.4degreesC)-the spontaneous hypothermic group. The cerebral perfusion pressure (CPP) was increased significantly by active cooling compared to the normothermic and hyperthermic groups. The mean cerebral blood flow (CBF) in patients with a brain temperature between 36.0degreesC and 37.5degreesC was 37.8 +/- 14.0 mL/100 g/min. The lowest CBF was measured in patients with a brain temperature