Vertrees R A, Tao W, Pencil S D, Sites J P, Althoff D P, Zwischenberger J B
Department of Surgery, University of Texas Medical Branch, Galveston 77554-0528, USA.
ASAIO J. 1996 Jul-Aug;42(4):250-4.
Whole body hyperthermia can be used for the treatment of metastatic cancer and human immunodeficiency virus infections. The therapeutic effects of hyperthermia are dependent upon the actual temperature of the target tissues. Therefore, homogeneous distribution of heat and precise control of temperature gradients is critical. To describe heat distribution during hyperthermia induced by venovenous perfusion, the authors used multiple channel temperature monitoring and a servo-regulated perfusion/heat exchange system. Young swine were randomly assigned to either a heated group (perfusion-induced hyperthermia, target core temperature at 43 degrees C, n = 6), or a control group (perfusion alone, target core temperature at 38 degrees C, n = 6). Blood was drained from the external jugular vein, heated with a computer assisted heat exchange system, and reinfused through the femoral vein at a flow of 10 ml/kg-1/min-1. Temperature probes in the esophagus, right and left tympanic canals, brain, pulmonary artery, arterial and venous blood, rectus spinae muscle, kidney, rectum, bone marrow, bladder, subcutaneous tissue, gluteus, and skin were simultaneously recorded. During the heat induction phase, the maximum water temperature was 54 degrees C, with a heating gradient of the blood (blood in-blood out) at 6 degrees C. The maximum temperature difference between tissues was 3.6 degrees C (kidney and esophagus) during heat induction, but decreased to 1.75 degrees C during maintenance. Bone marrow temperature was consistently 1-2 degrees C below the average core temperature of 43 degrees C throughout the experiment. The authors conclude that venovenous perfusion can predictably induce hyperthermia, but is associated with heterogenous temperature distribution among organs. Further studies are necessary to evaluate different perfusion and heating patterns to achieve homogenous hyperthermia.
全身热疗可用于治疗转移性癌症和人类免疫缺陷病毒感染。热疗的治疗效果取决于靶组织的实际温度。因此，热量的均匀分布和温度梯度的精确控制至关重要。为了描述静脉-静脉灌注诱导热疗期间的热分布，作者使用了多通道温度监测和伺服调节灌注/热交换系统。将幼猪随机分为加热组（灌注诱导热疗，目标核心温度为43℃，n = 6）或对照组（仅灌注，目标核心温度为38℃，n = 6）。从颈外静脉抽血，用计算机辅助热交换系统加热，然后以10 ml/kg-1/min-1的流速通过股静脉回输。同时记录食管、左右鼓室、脑、肺动脉、动静脉血、竖脊肌、肾、直肠、骨髓、膀胱、皮下组织、臀肌和皮肤中的温度探头。在热诱导阶段，最高水温为54℃，血液的加热梯度（血进-血出）为6℃。热诱导期间组织间的最大温差为3.6℃（肾和食管），但在维持期间降至1.75℃。在整个实验过程中，骨髓温度始终比43℃的平均核心温度低1-2℃。作者得出结论，静脉-静脉灌注可预测地诱导热疗，但与器官间温度分布不均有关。有必要进行进一步研究以评估不同的灌注和加热模式，以实现均匀热疗。
