Bass W Thomas, Lattanzio F A, Brayman G, Kootsey B, Aiello F, Perkins A M, Carr K L, Allison R C, Shaeffer J, Kelley R
Department of Pediatrics, Divisions of Neonatal Medicine, Eastern Virginia Medical School, Children's Hospital of The King's Daughters, Norfolk, VA, USA.
Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA, USA.
J Neonatal Perinatal Med. 2014;7(4):279-86. doi: 10.3233/NPM-14814041.
Therapeutic hypothermia (HT) has been shown to decrease death and severe disability in infants with hypoxic-ischemic encephalopathy (HIE). Rectal temperature (RT) is used to determine the temperature set-points for treatment with HT, however experimental studies have shown significant differences between RT and brain temperature during HT. Knowledge of actual brain temperature during HT might allow better determination of optimal degree of cooling and improve outcomes.
To compare measurements of brain temperature obtained by non-invasive radiometric thermometry (RadT) to direct tissue measurements in an experimental model of HT, and to use RadT in newborn infants with HIE undergoing HT.
RadT measurements of brain temperature were compared to fiber optic (Luxtron) thermometry measurements placed at a depth of 1.5 centimeters into the brain of cooled miniswine. Following validation studies, brain RadT and RT measurements were continuously recorded in thirty infants with HIE during HT and rewarming.
RadT and Luxtron probe temperatures were comparable in miniswine throughout a temperature range similar to therapeutic HT. RadT measurements of brain temperature were higher than RT in 60% of infants with HIE undergoing HT. Higher RadT measurements compared to RT were associated with cerebral white matter abnormalities (p = 0.01).
RadT provides a safe, passive and non-invasive way to measure brain temperature that can be used in the clinical setting. RadT may be helpful in determining the optimal degree of cooling and identifying infants at highest risk of brain injury.
治疗性低温(HT)已被证明可降低缺氧缺血性脑病(HIE)婴儿的死亡率和严重残疾率。直肠温度(RT)用于确定HT治疗的温度设定点,然而实验研究表明,HT期间RT与脑温之间存在显著差异。了解HT期间的实际脑温可能有助于更好地确定最佳降温程度并改善预后。
在HT实验模型中,比较通过非侵入性辐射测温法(RadT)获得的脑温测量值与直接组织测量值,并将RadT用于接受HT治疗的HIE新生儿。
将脑温的RadT测量值与放置在冷却小型猪脑内1.5厘米深处的光纤(Luxtron)测温测量值进行比较。经过验证研究后,在30例HIE婴儿接受HT和复温期间,持续记录脑RadT和RT测量值。
在整个类似于治疗性HT的温度范围内,小型猪的RadT和Luxtron探头温度具有可比性。在60%接受HT治疗的HIE婴儿中,脑温的RadT测量值高于RT。与RT相比,较高的RadT测量值与脑白质异常相关(p = 0.01)。
RadT提供了一种安全、被动且非侵入性的测量脑温方法,可用于临床环境。RadT可能有助于确定最佳降温程度,并识别脑损伤风险最高的婴儿。