Grahn D, Brock-Utne J G, Watenpaugh D E, Heller H C
Department of Biological Sciences, School of Medicine, Stanford University, Stanford, California 94305, USA.
J Appl Physiol (1985). 1998 Nov;85(5):1643-8. doi: 10.1152/jappl.1998.85.5.1643.
Peripheral vasoconstriction decreases thermal conductance of hypothermic individuals, making it difficult to transfer externally applied heat to the body core. We hypothesized that increasing blood flow to the skin of a hypothermic individual would enhance the transfer of exogenous heat to the body core, thereby increasing the rate of rewarming. External auditory meatus temperature (TEAM) was monitored in hypothermic subjects during recovery from general anesthesia. In 10 subjects, heat (45-46 degreesC, water-perfused blanket) was applied to a single forearm and hand that had been placed in a subatmospheric pressure environment (-30 to -40 mmHg) to distend the blood vessels. Heat alone was applied to control subjects (n = 6). The application of subatmospheric pressure resulted in a 10-fold increase in rewarming rates as determined by changes in TEAM [13.6 +/- 2.1 (SE) degreesC/h in the experimental group vs. 1.4 +/- 0.1 degreesC/h in the control group; P < 0.001]. In the experimental subjects, the rate of change of TEAM decreased sharply as TEAM neared the normothermic range.
外周血管收缩会降低体温过低者的热传导,使得难以将外部施加的热量传递至身体核心部位。我们推测,增加体温过低者皮肤的血流量会增强外源性热量向身体核心部位的传递,从而提高复温速率。在全身麻醉苏醒过程中,对体温过低的受试者监测外耳道温度(TEAM)。在10名受试者中,将热量(45 - 46摄氏度,水灌注毯)施加于置于负压环境(-30至-40 mmHg)以扩张血管的单前臂和手部。仅对对照受试者(n = 6)施加热量。根据TEAM的变化确定,负压的施加使复温速率提高了10倍[实验组为13.6±2.1(标准误)摄氏度/小时,对照组为1.4±0.1摄氏度/小时;P < 0.001]。在实验受试者中,随着TEAM接近正常体温范围,TEAM的变化速率急剧下降。