Brain temperature exceeds systemic temperature in head-injured patients
Brain temperature exceeds systemic temperature in head-injured patients
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DOI：
10.1097/00003246-199803000-00032
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发表时间：
1998-03-01
影响因子：
8.8
通讯作者：
Robertson, CS
中科院分区：
文献类型：
--
作者：
Rumana, CS;Gopinath, SP;Robertson, CS
目的：确定头部受伤患者的大脑、颈静脉球和核心体读数的温度差异，设计：前瞻性观察性研究，地点：大学附属县医院的神经外科重症监护室，患者：30 名严重头部受伤患者测量了大脑和核心体温，14 名患者还测量了颈静脉水平的颈静脉血 干预措施：无，测量和主要结果：脑部温度比核心体温平均升高 2.0 华氏度（1.1 摄氏度）。在个别患者中，脑部温度相对核心体温的平均升高范围为 -0.5 度到 3.8 华氏度（-0.30 度到 2.1 摄氏度）。颈静脉和核心体温相似，当脑灌注压降低至20至50毫米汞柱时，大脑和体温的差异增加。在接受巴比妥昏迷治疗的患者中，大脑和体温的差异下降。结论：直接测量受害患者头部温度是一种安全的程序，大脑温度通常会高于核心体温和颈静脉球温度，颈静脉温度测量不是脑部温度的良好测量方法，因为它反映的是身体温度，而不是脑部温度。这些发现支持监测脑部温度和脑部温度的潜在重要性。 对于头部严重受伤的患者控制发烧非常重要，因为脑部温度可能高于预期。
Objective: To identify the temperature differences in readings taken from the brain, jugular bulb, and core body in head injured patients,Design: Prospective, observational study,Setting: Neurosurgical intensive care unit of a university-affiliated county hospital,Patients: Thirty patients with severe head injuries had measurements of brain and core body temperatures, Fourteen patients also had measurements of jugular venous blood at the level of the jugular bulb.Interventions: None,Measurements and Main Results: Brain temperature was increased an average of 2.0 degrees F (1.1 degrees C) over the core body temperature, In individual patients, the average brain temperature increase over the core body temperature ranged from -0.5 degrees to 3.8 degrees F (-0.30 degrees to 2.1 degrees C). Jugular vein and core body temperatures were similar, The difference in the brain and body temperatures increased when cerebral perfusion pressure decreased to between 20 and 50 mm Hg. The difference in the brain and body temperatures decreased in those patients treated with barbiturate coma.Conclusions: Direct measurement of temperature in head in jured patients is a safe procedure, Temperatures in the brain are typically increased over the core body temperature and the jugular bulb temperatures, Jugular vein temperature measurement is not a good measurement of brain temperature since it reflects body, not brain temperature, These findings support the potential importance of monitoring brain temperature and the importance of controlling fever in severely head injured patients since brain temperature may be higher than expected.