Crowder C M, Tempelhoff R, Theard M A, Cheng M A, Todorov A, Dacey R G
Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
J Neurosurg. 1996 Jul;85(1):98-103. doi: 10.3171/jns.1996.85.1.0098.
Blood temperature at the jugular bulb was monitored in 10 patients undergoing neurovascular procedures that used induced mild hypothermia, and its correlation with surface brain, core, and peripheral temperatures was determined. The study was motivated by the difficulty encountered in directly measuring global brain temperature and the poor correlations between various core and peripheral sites temperatures and brain temperature, particularly during deep hypothermia. Although not statistically significant, previous studies have suggested a trend toward higher brain temperatures. Temperatures from the jugular bulb (collected using a No. 5 French Swan-Ganz catheter) as well as from subdural, pulmonary artery, esophagus, tympanic membrane, and bladder sites were analyzed during three surgical conditions: prior to incision, with the dura open, and after closure of the dura. No complications related to placement of the jugular bulb catheter, induced hypothermia, or temperature monitoring were seen. The authors found that jugular bulb temperature was similar to pulmonary artery and esophageal temperatures; although prior to incision it tended to be higher than that found at the pulmonary artery, most commonly by 0.2 degrees C. Surface brain temperature was cooler than all other temperatures (p < 0.05), except that of the tympanic membrane, and was particularly sensitive to environmental variations. Finally, as has been shown by others, bladder temperature lagged substantially behind core temperatures particularly during rapid cooling and rewarming of the patient. In summary, monitoring of jugular bulb temperature is a feasible technique, and temperatures measured in the jugular bulb are similar to core temperatures.
对10例接受使用轻度低温诱导的神经血管手术的患者进行颈静脉球部血温监测，并确定其与脑表面、核心及外周温度的相关性。本研究的动机是直接测量全脑温度存在困难，以及各种核心和外周部位温度与脑温度之间的相关性较差，尤其是在深度低温期间。尽管无统计学意义，但既往研究提示有脑温升高的趋势。在三种手术状态下分析了颈静脉球部（使用5号法国规格的Swan-Ganz导管采集）以及硬膜下、肺动脉、食管、鼓膜和膀胱部位的温度：切开前、硬脑膜开放时以及硬脑膜关闭后。未观察到与颈静脉球部导管置入、诱导低温或温度监测相关的并发症。作者发现颈静脉球部温度与肺动脉和食管温度相似；尽管切开前其温度往往高于肺动脉温度，最常见高0.2摄氏度。脑表面温度比所有其他温度都低（p<0.05），鼓膜温度除外，并且对环境变化特别敏感。最后，正如其他人所表明的，膀胱温度大幅滞后于核心温度，尤其是在患者快速降温和复温期间。总之，监测颈静脉球部温度是一种可行的技术，颈静脉球部测得的温度与核心温度相似。
