Thermodysregulation in persons with spinal cord injury: case series on use of the autonomic standards.
Thermodysregulation in persons with spinal cord injury: case series on use of the autonomic standards.
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DOI：
10.1038/s41394-017-0026-7
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发表时间：
2017-01-01
影响因子：
1.2
通讯作者：
Price, Michael
中科院分区：
文献类型：
--
作者：
Handrakis, John P;Trbovich, Michelle;Price, Michael
简介：尽管暴露于大范围的环境温度，但将核心体温（Tcore）维持在窄范围（37±0.6°C）内的能力对于为重要器官、中枢神经系统（CNS）和细胞过程提供最佳环境以发挥功能至关重要。高水平（T6以上）脊髓损伤（SCI）中断自主神经系统的能力，进行下丘脑调节体温调节机制的散热和保护。这种中断使高水平SCI患者即使暴露在相对温和的环境温度下也容易出现体温过高和过低。自主神经标准的目标是使临床医生能够快速识别那些个体与SCI谁可能是最危险的体温调节功能障碍.CASE介绍：情况1：热衰竭，情况2：中暑在没有中枢神经系统症状，情况3：热exhaustion.Discussion：这三种情况下表现出的迹象和症状，可能伴随着体温过高的人与SCI。发病可能相当迅速，病情持续，尽管环境温度远低于预期的强度，而预期的强度是诱导健全（AB）人出现类似病情所必需的。案例研究中的人员对自主神经标准中出汗部分的温度调节和自主控制的反应将确定他们是脆弱的，并保证向他们及其护理人员提供适当的暴露指南和预防措施。
INTRODUCTION: The ability to maintain core body temperature (Tcore) within a narrow range (37±0.6°C), despite exposure to a wide range of ambient temperatures, is essential in order to provide an optimal environment for vital organs, the central nervous system (CNS), and cellular processes to function. High-level (above T6) spinal cord injury (SCI) interrupts the autonomic nervous system's ability to carry out hypothalamic regulation of thermoregulatory mechanisms for both heat dissipation and conservation. This interruption leaves persons with high-level SCI vulnerable to hyper and hypothermia even during exposure to relatively mild ambient temperatures. The goal of the Autonomic Standards is to enable the clinician to quickly identify those individuals with SCI who may be most at risk for thermoregulatory dysfunction.CASE PRESENTATION: Case 1: Heat Exhaustion, Case 2: Heat Stroke in absence of CNS symptoms, Case 3: Heat Exhaustion.DISCUSSION: The three cases demonstrate the signs and symptoms that may accompany hyperthermia in persons with SCI. The onset may be quite rapid and the condition persistent, despite ambient temperatures being much less intense than expected to be necessary to induce similar conditions in able-bodied (AB) persons. The responses of the persons in the case studies to the temperature regulation and autonomic control of sweating sections of the Autonomic Standards would identify them as being vulnerable and warrant providing appropriate exposure guidelines and precautions to them and their caregivers.