创伤患者核心体温昼夜节律的恶化与脓毒症。

Exacerbation of circadian rhythms of core body temperature and sepsis in trauma patients.

机构信息

Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Microbes Evolution Phylogénie et Infections (MEPHI), Institut Hospitalo-Universitaire (IHU)-Méditerranée Infection, Marseille, France; Aix Marseille Université, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive - Réanimation, Marseille, France.

出版信息

J Crit Care. 2020 Dec;60:23-26. doi: 10.1016/j.jcrc.2020.07.010. Epub 2020 Jul 16.

DOI:10.1016/j.jcrc.2020.07.010

PMID:32731102

Abstract

PURPOSE

This study aimed to describe by mathematical modeling an accurate course of core body temperature (CBT) in severe trauma patients and its relation to sepsis.

METHODS

In a cohort of severe trauma, the CBT measurements were collected for 24 h on day 2 after admission and rhythmicity assessed by Fourier transform and Cosinor analysis to describe circadian features (frequency and amplitude). CBT was compared between patients who developed sepsis or not during the early ICU stay.

RESULTS

33 patients were included in this analysis. 24 patients (73%) had a predominant rhythm of 24 h (period). The main period was lower in the 9 remaining patients (6 of 12 h, 1 of 8 h, and 2 of 6 h). Other significant frequencies of oscillation (second and third frequencies) were found, which showed an association of several well-marked rhythms. Patients with sepsis (n = 12) had a significantly higher level of CBT, but also more intense rhythms and higher amplitudes of CBT.

CONCLUSION

Trauma patients exhibit complex temperature circadian rhythms. Early exacerbation of the temperature rhythmicity (in frequency and amplitude) is associated with the development of sepsis. This observation accentuates the concept of circadian disruption and sepsis in ICU patients.

摘要

目的

本研究旨在通过数学建模描述严重创伤患者核心体温（CBT）的准确变化过程及其与脓毒症的关系。

方法

在严重创伤患者队列中，在入院后第 2 天连续 24 小时采集 CBT 测量值，并通过傅里叶变换和余弦分析评估节律性，以描述昼夜节律特征（频率和幅度）。比较早期 ICU 住院期间发生或未发生脓毒症的患者的 CBT。

结果

本分析纳入 33 名患者。24 名患者（73%）具有 24 小时的主要节律（周期）。其余 9 名患者的主要周期较低（6 小时、12 小时、8 小时和 6 小时各 1 例）。还发现了其他显著的振荡频率（第二和第三频率），表明存在多个明显的节律关联。发生脓毒症的患者（n=12）的 CBT 水平显著升高，但节律性更强，CBT 的幅度也更高。