Significance of Differences Between Brain Temperature and Core Temperature (Delta T) During Mild Hypothermia in Patients With Diffuse Axonal Injury
Significance of Differences Between Brain Temperature and Core Temperature (Delta T) During Mild Hypothermia in Patients With Diffuse Axonal Injury
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DOI：
10.2176/nmc.51.551
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发表时间：
2011-08-01
影响因子：
1.9
通讯作者：
Suzuki, Michiyasu
中科院分区：
文献类型：
--
作者：
Suehiro, Eiichi;Fujisawa, Hirosuke;Suzuki, Michiyasu
对11例严重颅脑损伤患者（其中5例因弥漫性轴突损伤（DAI）保守治疗（DAI组）和6例因血肿行去骨瓣减压术（SDH组））低温治疗期间脑温和膀胱温度（delta T）的差异以及Delta T与脑灌注压（CPP）和颈静脉氧饱和度（SjO（2））的关系进行研究。所有患者均接受低温治疗。通过实质内导管监测脑温度。膀胱温度用作核心温度。连续测量SjO(2)。所有患者的结果在出院时均使用格拉斯哥结果量表进行评估。 SDH组的Delta T显着低于DAI组。调查期间未发现 delta T 与 CPP 之间存在任何关系。在 DAI 组中观察到 delta T 和 SjO(2) 之间存在显着相关性，但在 SDH 组中则不然。去骨瓣减压术通过外部环境因素影响脑温度。脑温度测量可能是 DAI 和颅骨闭合患者低温期间脑血流量和脑代谢的可靠指标。需要更多的经验来测试这个建议。
The differences between brain and bladder temperature (delta T), and the relationship of delta T to cerebral perfusion pressure (CPP) and jugular venous oxygen saturation (SjO(2)) were studied during hypothermia in 11 patients with severe traumatic brain injury, of whom 5 underwent conservative treatment for diffuse axonal injury (DAI) (DAI group) and 6 who underwent decompressive craniectomy for hematoma (SDH group). All patients underwent hypothermia treatment. Brain temperature was monitored via an intraparenchymal catheter. Bladder temperature was used as the core temperature. SjO(2) was measured continuously. The outcome of all patients was evaluated at discharge using the Glasgow Outcome Scale. Delta T in the SDH group was significantly lower than that in the DAI group. No relationship was found between delta T and CPP during the investigation period. A significant correlation between delta T and SjO(2) was seen in the DAI group, but not in the SDH group. Decompressive craniectomy affects the brain temperature through external environmental factors. Measurement of brain temperature may be a reliable indicator of cerebral blood flow and brain metabolism in patients with DAI and closed cranium during hypothermia. Further experience is required to test this proposal.