Bazley Faith A, Pashai Nikta, Kerr Candace L, All Angelo H
1 Singapore Institute for Neurotechnology, National University of Singapore , Singapore .
Ther Hypothermia Temp Manag. 2014 Sep;4(3):115-24. doi: 10.1089/ther.2014.0002. Epub 2014 Jul 14.
Local and general hypothermia are used to treat spinal cord injury (SCI), as well as other neurological traumas. While hypothermia is known to provide significant therapeutic benefits due to its neuroprotective nature, it is unclear how the treatment may affect healthy tissues or whether it may cause undesired temperature changes in areas of the body that are not the targets of treatment. We performed 2-hour moderate general hypothermia (32°C core) or local hypothermia (30°C spinal cord) on rats that had received either a moderate contusive SCI or laminectomy (control) while monitoring temperatures at three sites: the core, spinal cord, and cortex. First, we identified that injured rats that received general hypothermia exhibited larger temperature drops at the spinal cord (-3.65°C, 95% confidence intervals [CIs] -3.72, -3.58) and cortex (-3.64°C, CIs -3.73, -3.55) than uninjured rats (spinal cord: -3.17°C, CIs -3.24, -3.10; cortex: -3.26°C, CIs -3.34, -3.17). This was found due to elevated baseline temperatures in the injured group, which could be due to inflammation. Second, both general hypothermia and local hypothermia caused a significant reduction in the cortical temperature (-3.64°C and -1.18°C, respectively), although local hypothermia caused a significantly lower drop in cortical temperature than general hypothermia (p<0.001). Lastly, the rates of rewarming of the cord were not significantly different among the methods or injury groups that were tested; the mean rate of rewarming was 0.13±0.1°C/min. In conclusion, local hypothermia may be more suitable for longer durations of hypothermia treatment for SCI to reduce temperature changes in healthy tissues, including the cortex.
局部和全身低温疗法用于治疗脊髓损伤(SCI)以及其他神经创伤。虽然已知低温疗法因其神经保护特性而具有显著的治疗益处,但尚不清楚该疗法如何影响健康组织,或者它是否会在身体非治疗靶点区域引起不期望的温度变化。我们对接受中度挫伤性脊髓损伤或椎板切除术(对照)的大鼠进行了2小时的中度全身低温(核心温度32°C)或局部低温(脊髓温度30°C),同时在三个部位监测温度:核心、脊髓和皮层。首先,我们发现接受全身低温治疗的损伤大鼠在脊髓(-3.65°C,95%置信区间[CI]-3.72,-3.58)和皮层(-3.64°C,CI-3.73,-3.55)的温度下降幅度大于未受伤大鼠(脊髓:-3.17°C,CI-3.24,-3.10;皮层:-3.26°C,CI-3.34,-3.17)。这是由于损伤组的基线温度升高,这可能是炎症所致。其次,全身低温和局部低温均导致皮层温度显著降低(分别为-3.64°C和-1.18°C),尽管局部低温导致的皮层温度下降幅度明显低于全身低温(p<0.001)。最后,在所测试的方法或损伤组中,脊髓复温速率没有显著差异;平均复温速率为0.13±0.1°C/分钟。总之,局部低温可能更适合对脊髓损伤进行更长时间的低温治疗,以减少包括皮层在内的健康组织中的温度变化。