title: Relation between brain oxygen metabolism and temperature gradient between brain and bladder.
abstract: Brain temperature is slightly higher than systemic core temperature normally. Fluctuations of a temperature gradient between brain and core body have recently been reported after a severe brain insult. The pathophysiological significance of the gradient fluctuations is unclear. This study aims to identify the gradient fluctuations between brain and core temperatures after a brain insult. Temperature gradient (brain temperature minus bladder temperature: degrees C) was measured in 11 patients (125 points) with severe brain injury (4 patients with subarachnoid hemorrhage, 4 with cerebral hemorrhage. and 3 with traumatic brain injury). Cerebral perfusion pressure (CPP; mmHg) and jugular venous blood saturation (SjO2; %) was also measured. The average gradient was 0.29 +/- 0.285 degrees C when CPP was above 50 mmHg. SjO2 was inversely related to the temperature gradient in a significant manner (r = 0.472; P < 0.0001). Temperature gradients tended to increase and then decrease when CPP < 50 mmHg. This study demonstrates that increased temperature gradient has a significant inverse correlation with SjO2 at CPP > 50 mmHg. The current results suggest that the fluctuations in temperature gradient in critical conditions reflect brain ischemia.
authors.affiliation: Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Tokyo, Japan. sakurai@med.nihon-u.ac.jp
authors.forename: A
authors.initials: A
authors.lastname: Sakurai
authors.forename: K
authors.initials: K
authors.lastname: Kinoshita
authors.forename: T
authors.initials: T
authors.lastname: Atsumi
authors.forename: T
authors.initials: T
authors.lastname: Moriya
authors.forename: A
authors.initials: A
authors.lastname: Utagawa
authors.forename: N
authors.initials: N
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001831:Body Temperature; D001921:Brain / Q000378:metabolism / Q000503:physiopathology*; D001930:Brain Injuries / Q000503:physiopathology*; D002543:Cerebral Hemorrhage / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D013345:Subarachnoid Hemorrhage / Q000503:physiopathology*; D001743:Urinary Bladder / Q000503:physiopathology*