Sheffield C W, Sessler D I, Hunt T K
Department of Surgery, University of California, San Francisco 94114-0648.
Acta Anaesthesiol Scand. 1994 Apr;38(3):201-5. doi: 10.1111/j.1399-6576.1994.tb03873.x.
Small changes in core temperature profoundly alter cutaneous blood flow, a major factor influencing resistance to wound infection. Furthermore, when measured in vitro, various immune functions are temperature dependent in the physiological range. Accordingly, we tested the hypothesis that mild hypothermia impairs and mild hyperthermia improves resistance to dermal infections. Thirty-two guinea pigs were anesthetized for 6 h using 1.5% (1.25 MAC) inspired isoflurane. Their core temperatures were maintained at either 39 degrees C (normal for guinea pigs, n = 11), 36 degrees C (n = 12), or 41 degrees C (n = 9). One h after induction of anesthesia, 2 x 10(8) E. coli were injected intradermally with a 26-g needle at eight sites on each animal's back. Core temperatures were not controlled after recovery from anesthesia, and animals in each group were maintained in the same environment. Twenty-four h after injection, the area of induration surrounding each injection site was measured. This is a standard test of resistance to wound infection. Values were compared using one-way ANOVA and Scheffé's S tests. Results are presented as means +/- standard deviations; differences were considered significant when P < 0.05. Areas of inflammation on the hypothermic animals were significantly larger (48 +/- 10 mm2) than those on normothermic (36 +/- 10 mm2) or hyperthermic (37 +/- 6 mm2) animals. These data suggest that mild hypothermia during anesthesia significantly impairs resistance to dermal infection. In contrast, mild hyperthermia does not appear to be protective.
核心体温的微小变化会深刻改变皮肤血流量,而皮肤血流量是影响伤口感染抵抗力的一个主要因素。此外,在体外测量时,各种免疫功能在生理范围内都依赖于温度。因此,我们检验了这样一个假设:轻度低温会损害、而轻度高温会提高对皮肤感染的抵抗力。32只豚鼠使用1.5%(1.25MAC)的吸入异氟醚麻醉6小时。它们的核心体温维持在39℃(豚鼠的正常体温,n = 11)、36℃(n = 12)或41℃(n = 9)。麻醉诱导1小时后,用26号针头在每只动物背部的8个部位皮内注射2×10⁸大肠杆菌。从麻醉中恢复后不再控制核心体温,每组动物都饲养在相同的环境中。注射24小时后,测量每个注射部位周围的硬结面积。这是对伤口感染抵抗力的一项标准测试。使用单向方差分析和谢费(Scheffé)S检验比较数值。结果以平均值±标准差表示;当P<0.05时,差异被认为具有显著性。低温动物的炎症面积(48±10mm²)明显大于正常体温动物(36±10mm²)或高温动物(37±6mm²)。这些数据表明,麻醉期间的轻度低温会显著损害对皮肤感染的抵抗力。相比之下,轻度高温似乎没有保护作用。