Robins H I, Grossman J, Davis T E, AuBuchon J P, Dennis W
Cancer Res. 1983 May;43(5):2018-22.
After review of the published clinical experience with systemic hypothermia, we concluded that a simple system which controls radiant heat balance to supplement metabolic heat might provide several advantages, including: (a) decreased morbidity; (b) elimination of the requirement for general anesthesia; (c) improved patient comfort; (d) favorable cost-benefit considerations. We have tested a prototype radiant heat device for whole-body hyperthermia (WBH) in patients with disseminated cancer. From preclinical evaluation of this device, the lightly anesthetized pig was found to be an ideal model for WBH. This species has physiological characteristics closely resembling those of humans. The pig's core, pulmonary artery, liver, rectal, and esophageal temperatures were raised to 41.8 degrees in 80 to 90 min. The air temperatures near the chamber wall never exceeded 65 degrees while the air temperature adjacent to the animal was 46 degrees. Skin temperatures were approximately 42.5 degrees at a core temperature of 41.8 degrees. Once the core temperature is raised to 41.8 degrees, this temperature is maintainable for approximately 3.5 hr without additional external heating if evaporative losses are controlled. Prolonged WBH was accomplished with light sedation and without the requirement for endotracheal intubation. No significant acute toxicity was encountered in a series of 6 pigs undergoing 9 separate exposures to WBH. From these results, we conclude that our radiant heat apparatus is feasible for clinical trials. Additionally, the use of the pig as an appropriate animal model for further physiological and pharmacological WBH studies is strongly recommended.
在回顾了已发表的关于全身低温的临床经验后,我们得出结论,一个控制辐射热平衡以补充代谢热的简单系统可能具有几个优点,包括:(a)发病率降低;(b)无需全身麻醉;(c)提高患者舒适度;(d)有利的成本效益考量。我们已经在患有转移性癌症的患者中测试了一种用于全身热疗(WBH)的辐射热装置原型。通过对该装置的临床前评估,发现轻度麻醉的猪是WBH的理想模型。该物种的生理特征与人类非常相似。猪的核心温度、肺动脉温度、肝脏温度、直肠温度和食管温度在80至90分钟内升至41.8摄氏度。腔壁附近的空气温度从未超过65摄氏度,而动物附近的空气温度为46摄氏度。在核心温度为41.8摄氏度时,皮肤温度约为42.5摄氏度。一旦核心温度升至41.8摄氏度,如果控制蒸发损失,该温度可在无需额外外部加热的情况下维持约3.5小时。通过轻度镇静即可实现长时间的WBH,无需气管插管。在一系列6头猪接受9次单独的WBH暴露中,未发现明显的急性毒性。根据这些结果,我们得出结论,我们的辐射热装置可用于临床试验。此外,强烈建议将猪用作进一步进行WBH生理和药理研究的合适动物模型。