Mrozek Ségolène, Vardon Fanny, Geeraerts Thomas
Department of Anesthesia and Critical Care, University Hospital of Toulouse, University Paul Sabatier, Toulouse, France.
Anesthesiol Res Pract. 2012;2012:989487. doi: 10.1155/2012/989487. Epub 2012 Dec 26.
The regulation of brain temperature is largely dependent on the metabolic activity of brain tissue and remains complex. In intensive care clinical practice, the continuous monitoring of core temperature in patients with brain injury is currently highly recommended. After major brain injury, brain temperature is often higher than and can vary independently of systemic temperature. It has been shown that in cases of brain injury, the brain is extremely sensitive and vulnerable to small variations in temperature. The prevention of fever has been proposed as a therapeutic tool to limit neuronal injury. However, temperature control after traumatic brain injury, subarachnoid hemorrhage, or stroke can be challenging. Furthermore, fever may also have beneficial effects, especially in cases involving infections. While therapeutic hypothermia has shown beneficial effects in animal models, its use is still debated in clinical practice. This paper aims to describe the physiology and pathophysiology of changes in brain temperature after brain injury and to study the effects of controlling brain temperature after such injury.
脑温调节很大程度上取决于脑组织的代谢活动,并且仍然很复杂。在重症监护临床实践中,目前强烈建议对脑损伤患者进行核心体温的持续监测。严重脑损伤后,脑温通常高于体核温度,且可独立于体核温度而变化。研究表明,在脑损伤情况下,大脑对温度的微小变化极其敏感且脆弱。预防发热已被提议作为限制神经元损伤的一种治疗手段。然而,创伤性脑损伤、蛛网膜下腔出血或中风后的体温控制可能具有挑战性。此外,发热也可能具有有益作用,尤其是在涉及感染的情况下。虽然治疗性低温在动物模型中已显示出有益效果,但其在临床实践中的应用仍存在争议。本文旨在描述脑损伤后脑温变化的生理学和病理生理学,并研究此类损伤后控制脑温的效果。