Abstract:
Our core body temperature is held around [Formula: see text]C by an effective internal thermoregulatory system. However, various clinical scenarios have a more favorable outcome under external temperature regulation. Therapeutic hypothermia, for example, was found beneficial for the outcome of resuscitated cardiac arrest patients due to its protection against cerebral ischemia. Nonetheless, practice shows that outcomes of targeted temperature management vary considerably in dependence on individual tissue damage levels and differences in therapeutic strategies and protocols. Here, we address these differences in detail by means of computational modeling. We develop a multi-segment and multi-node thermoregulatory model that takes into account details related to specific post-cardiac arrest-related conditions, such as thermal imbalances due to sedation and anesthesia, increased metabolic rates induced by inflammatory processes, and various external cooling techniques. In our simulations, we track the evolution of the body temperature in patients subjected to post-resuscitation care, with particular emphasis on temperature regulation via an esophageal heat transfer device, on the examination of the alternative gastric cooling with ice slurry, and on how anesthesia and the level of inflammatory response influence thermal behavior. Our research provides a better understanding of the heat transfer processes and therapies used in post-cardiac arrest patients.
摘要:
我们的核心体温由有效的内部体温调节系统保持在[公式:见正文]C左右。然而,在外部温度调节下,各种临床方案都有更有利的结果。治疗性低温,例如,由于其对脑缺血的保护作用,因此发现对复苏的心脏骤停患者的预后有益。尽管如此,实践表明,目标温度管理的结果因个体组织损伤水平和治疗策略和方案的差异而有很大差异.这里,我们通过计算建模来详细解决这些差异。我们开发了一个多段和多节点体温调节模型,该模型考虑了与特定心脏骤停后相关疾病相关的详细信息,如镇静和麻醉引起的热不平衡,炎症过程引起的代谢率增加,和各种外部冷却技术。在我们的模拟中,我们跟踪接受复苏后护理的患者体温的演变,特别强调通过食道传热装置进行温度调节,在检查用冰浆替代胃冷却时,以及麻醉和炎症反应水平如何影响热行为。我们的研究为心脏骤停后患者的传热过程和治疗提供了更好的理解。