Menzel M, Rieger A, Soukup J, Roth S, Furka I, Miko I, Molnar P, Hennig C, Radke J
Department of Anaesthesiology and Intensive Care Medicine, Martin-Luther-University Halle-Wittenberg.
Anaesthesist. 1998 Jul;47(7):600-4. doi: 10.1007/s001010050602.
Hypothermia has a considerable protective effect during brain ischemia. On the other hand small increases of brain temperature have a remarkable effect on the exacerbation of neurological damage following an ischemic event. Hyperthermia of the brain tissue after severe head injury is described. The effect of acutely increased intracranial pressure on cerebrovenous blood temperature is not described yet. The aim of this study was to investigate the relationship between temperature in the cerebrovenous compartment (Tcv) and changes of the CPP in an animal model of raised intracranial pressure.
A thermocouple was inserted in the sagittal sinus in 9 pigs under general anesthesia. By stepwise inflating a supracerebral and infratentorial placed balloon catheter intracranial pressure (ICP) was increased and CPP concomitantly decreased. The central body temperature was measured simultaneously in the abdominal aorta (Ta) with a second thermocouple.
In our model th Tcv was lower than Ta at the beginning of the ICP increase. The mean difference between Ta and Tcv, (delta Ta-cv) was 0.86 degree C (+/- 0.44) prior to ICP increase and 1.19 degrees C (0.58) at the maximum ICP increase. Thus, delta Tav increased during CPP reduction. This relation was represented by an adjusted R(square) of r2 = 0.89 (p < 0.001).
The CPP decrease, caused by an increasing ICP, results in changes of the cerebrovenous blood temperature. Interpreting the present results the experimental situation of a relative colder cerebral compartment in comparison to the central body temperature has to be considered. However, the results imply, that simultaneous temperature monitoring of the central body temperature and the cerebrovenous blood temperature is an additional source of information about relative changes of the CBF.
低温在脑缺血期间具有相当大的保护作用。另一方面,脑温的小幅升高对缺血事件后神经损伤的加重有显著影响。描述了重度颅脑损伤后脑组织的高热情况。急性升高的颅内压对脑静脉血温度的影响尚未见报道。本研究的目的是在颅内压升高的动物模型中研究脑静脉腔温度(Tcv)与脑灌注压(CPP)变化之间的关系。
在9头全麻猪的矢状窦插入热电偶。通过逐步向置于脑上和幕下的球囊导管充气,使颅内压(ICP)升高,同时CPP降低。用第二个热电偶同时测量腹主动脉的中心体温(Ta)。
在我们的模型中,ICP升高开始时Tcv低于Ta。ICP升高前Ta与Tcv的平均差值(δTa-cv)为0.86℃(±0.44),ICP最大升高时为1.19℃(0.58)。因此,在CPP降低期间δTav升高。这种关系用调整后的决定系数r2 = 0.89表示(p < 0.001)。
ICP升高导致的CPP降低会引起脑静脉血温度的变化。解释目前的结果时,必须考虑与中心体温相比脑腔相对较冷的实验情况。然而,结果表明,同时监测中心体温和脑静脉血温度是关于脑血流量相对变化的额外信息来源。