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早产儿的体温调节:一个数学模型。

Thermoregulation in premature infants: A mathematical model.

作者信息

Pereira Carina Barbosa, Heimann Konrad, Czaplik Michael, Blazek Vladimir, Venema Boudewijn, Leonhardt Steffen

机构信息

Chair for Medical Information Technology, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany.

Department of Neonatology, University Children's Hospital, University Hospital RWTH Aachen, Germany.

出版信息

J Therm Biol. 2016 Dec;62(Pt B):159-169. doi: 10.1016/j.jtherbio.2016.06.021. Epub 2016 Jul 5.

Abstract

PURPOSE

In 2010, approximately 14.9 million babies (11.1%) were born preterm. Because preterm infants suffer from an immature thermoregulatory system they have difficulty maintaining their core body temperature at a constant level. Therefore, it is essential to maintain their temperature at, ideally, around 37°C. For this, mathematical models can provide detailed insight into heat transfer processes and body-environment interactions for clinical applications.

METHODS

A new multi-node mathematical model of the thermoregulatory system of newborn infants is presented. It comprises seven compartments, one spherical and six cylindrical, which represent the head, thorax, abdomen, arms and legs, respectively. The model is customizable, i.e. it meets individual characteristics of the neonate (e.g. gestational age, postnatal age, weight and length) which play an important role in heat transfer mechanisms. The model was validated during thermal neutrality and in a transient thermal environment.

RESULTS

During thermal neutrality the model accurately predicted skin and core temperatures. The difference in mean core temperature between measurements and simulations averaged 0.25±0.21°C and that of skin temperature averaged 0.36±0.36°C. During transient thermal conditions, our approach simulated the thermoregulatory dynamics/responses. Here, for all infants, the mean absolute error between core temperatures averaged 0.12±0.11°C and that of skin temperatures hovered around 0.30°C.

CONCLUSIONS

The mathematical model appears able to predict core and skin temperatures during thermal neutrality and in case of a transient thermal conditions.

摘要

目的

2010年,约有1490万婴儿(11.1%)早产。由于早产儿的体温调节系统不成熟,他们难以将核心体温维持在恒定水平。因此,将他们的体温维持在理想的37°C左右至关重要。为此,数学模型可为临床应用中的热传递过程和身体与环境的相互作用提供详细的见解。

方法

提出了一种新的新生儿体温调节系统多节点数学模型。它由七个隔室组成,一个球形和六个圆柱形,分别代表头部、胸部、腹部、手臂和腿部。该模型是可定制的,即它符合新生儿的个体特征(如胎龄、出生后年龄、体重和身长),这些特征在热传递机制中起着重要作用。该模型在热中性和瞬态热环境下进行了验证。

结果

在热中性状态下,该模型准确预测了皮肤和核心温度。测量值与模拟值之间的平均核心温度差异平均为0.25±0.21°C,皮肤温度差异平均为0.36±0.36°C。在瞬态热条件下,我们的方法模拟了体温调节动态/反应。在此,对于所有婴儿,核心温度之间的平均绝对误差平均为0.12±0.11°C,皮肤温度的平均绝对误差徘徊在0.30°C左右。

结论

该数学模型似乎能够预测热中性状态下以及瞬态热条件下的核心温度和皮肤温度。

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