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Rectal temperature reflects tympanic temperature during mild induced hypothermia in nonintubated subjects.

https://arctichealth.org/en/permalink/ahliterature5760
Source
J Neurosurg Anesthesiol. 2004 Jul;16(3):232-5
Publication Type
Article
Date
Jul-2004
Author
Richard M Zweifler
Marc E Voorhees
M Asim Mahmood
Mel Parnell
Author Affiliation
University of South Alabama Stroke Center, Mobile, 36617, USA. rzweifle@usouthal.edu
Source
J Neurosurg Anesthesiol. 2004 Jul;16(3):232-5
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Acetaminophen - pharmacology
Adult
Analgesics, Non-Narcotic - pharmacology
Analgesics, Opioid - pharmacology
Body Temperature - physiology
Female
Humans
Hypothermia, Induced
Male
Meperidine - pharmacology
Rectum - physiology
Research Support, Non-U.S. Gov't
Rewarming
Shivering
Tympanic Membrane - physiology
Abstract
INTRODUCTION: Mild induced hypothermia holds promise as an effective neuroprotective strategy following acute stroke and cardiac arrest. Dependable noninvasive measurements of brain temperature are imperative for the investigation and clinical application of therapeutic hypothermia. Although the tympanic membrane temperature correlates best with brain temperature, it is a cumbersome location to record from continuously in the clinical setting. Data are lacking regarding the relationship between rectal and tympanic temperatures in nonintubated humans undergoing induced hypothermia via surface cooling. METHODS: We induced mild hypothermia in healthy volunteers using a novel surface cooling method (Arctic Sun Temperature Management System, Medivance, Inc., Louisville, CO). Core temperatures were recorded at the tympanic membrane (Ttym) and rectum (Trec). The gradient was defined as (Ttym-Trec). Controlled hypothermia was maintained for up to 300 minutes with a target Ttym of 34 degrees C to 35 degrees C; subjects were then actively rewarmed to a target Ttym of 36 degrees C over 1.5 to 3 hours. RESULTS: Twenty-two volunteers (10 males and 12 females) 31 +/- 8 years of age were studied. Subjects showed a triphasic temperature response: induction, maintenance, and rewarming. The mean gradient at baseline was -0.1 +/- 0.3 degrees C and the maximum gradient increased to -0.6 +/- 0.4 degrees C at 105 minutes. During maintenance of hypothermia (from 150 to 300 minutes), the mean gradient was -0.3 +/- 0.5 degrees C (95% confidence limits, -1.2 degrees C to 0.6 degrees C). CONCLUSIONS:: Our data suggest that Ttym and Trec are not related during the induction of hypothermia via surface cooling but correlate during the maintenance phase, with a -0.3 degrees C gradient. These findings support the use of rectal temperature as a measure of tympanic and, therefore, brain temperature during maintenance of induced hypothermia in nonintubated humans.
Notes
Erratum In: J Neurosurg Anesthesiol. 2005 Jan;17(1):following table of contents
PubMed ID
15211161 View in PubMed
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Transcranial Doppler ultrasonographic evaluation of middle cerebral artery hemodynamics during mild hypothermia.

https://arctichealth.org/en/permalink/ahliterature5755
Source
J Neuroimaging. 2005 Oct;15(4):336-40
Publication Type
Article
Date
Oct-2005
Author
M Asim Mahmood
Marc E Voorhees
Mel Parnell
Richard M Zweifler
Author Affiliation
University of South Alabama Stroke Center, 2541 Fillingim Street, Ste. 10-I, Mobile, AL 36617, USA. amahmood@usouthal.edu
Source
J Neuroimaging. 2005 Oct;15(4):336-40
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Adult
Blood Flow Velocity
Blood pressure
Cerebrovascular Circulation
Female
Heart rate
Humans
Hypothermia, Induced
Male
Middle Cerebral Artery - ultrasonography
Oxygen - blood
Pulsatile Flow
Research Support, Non-U.S. Gov't
Ultrasonography, Doppler, Transcranial
Abstract
BACKGROUND AND PURPOSE: Induced hypothermia holds promise as an effective neuroprotective strategy following cerebral ischemia. The effect of mild hypothermia on cerebral hemodynamics is not well known. The authors investigated the influence of brain temperature on middle cerebral artery (MCA) mean flow velocity (MCA FV) and pulsatility index (MCA PI) in nonintubated, healthy volunteers undergoing mild induced hypothermia. METHODS: Mild hypothermia (target tympanic membrane temperature [T tym] degrees C) was induced in subjects using the Arctic Sun Temperature Management System (Medivance, Inc, Louisville, CO). MCA FV and MCA PI were recorded bilaterally with a 2 MHz pulsed probe every 30 minutes via the transtemporal window. RESULTS: Eighteen subjects (8 males, 10 females) 32 +/- 8 years of age were studied. Multivariate analysis indicated that MCA FV increased with increasing change in temperature (baseline tympanic temperature-tympanic temperature [DeltaT tym]) (P
PubMed ID
16254398 View in PubMed
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