Differences in brain temperature and cerebral blood flow during selective head versus whole-body cooling

Abbot R. Laptook, Lina Shalak, Ron J T Corbett

Research output: Contribution to journalArticle

118 Citations (Scopus)

Abstract

Objective. To compare brain temperature and cerebral blood flow (CBF) during head and body cooling, with and without systemic hypoxemia. Methods. Seventeen newborn swine were studied for either measurement of brain temperature alone (n = 9) or measurement of brain temperature and CBF (n = 8). All animals were ventilated and instrumented, and temperature probes were inserted into the rectum, into the brain at depths of 2 and 1 cm from the cortical surface, and on the dural surface. Blood flow was measured with microspheres. The protocol consisted of a control period, an interval of either head or body cooling, and cooling with 15 minutes of superimposed hypoxia. After a 1-hour recovery period, animals were exposed to the same sequence except that the alternate mode of cooling was evaluated. Results. Head cooling with a constant rectal temperature resulted in an increase in the temperature gradient across the brain from the warmer central structures to the cooler periphery (brain 2 cm - dura temperature: 1.3 ± 1.1°C at control to 7.5 ± 3.5°C during cooling). Hypoxia superimposed on head cooling decreased the temperature gradient by at least 50%. In contrast, body cooling was associated with an unchanged temperature gradient across the brain (brain 2 cm - dura temperature: 1.5 ± 1.2°C at control to 1.1 ± 0.9°C during cooling). Hypoxia superimposed on body cooling did not change brain temperature. Both modes of brain cooling resulted in similar reductions of global CBF (∼40%) and O2 uptake. Conclusion. Brain hypothermia achieved through head or body cooling results in different brain temperature gradients. Alterations in systemic variables (ie, hypoxemia) alters brain temperature differently in these 2 modes of brain cooling. The mode of brain cooling may affect the efficacy of modest hypothermia as a neuroprotective therapy.

Original languageEnglish (US)
Pages (from-to)1103-1110
Number of pages8
JournalPediatrics
Volume108
Issue number5
DOIs
StatePublished - 2001

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Cerebrovascular Circulation
Head
Temperature
Brain
Hypothermia

Keywords

  • Body cooling
  • Brain cooling
  • Cerebral blood flow
  • Head cooling
  • Hypothermia
  • Hypoxia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Differences in brain temperature and cerebral blood flow during selective head versus whole-body cooling. / Laptook, Abbot R.; Shalak, Lina; Corbett, Ron J T.

In: Pediatrics, Vol. 108, No. 5, 2001, p. 1103-1110.

Research output: Contribution to journalArticle

Laptook, Abbot R. ; Shalak, Lina ; Corbett, Ron J T. / Differences in brain temperature and cerebral blood flow during selective head versus whole-body cooling. In: Pediatrics. 2001 ; Vol. 108, No. 5. pp. 1103-1110.
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abstract = "Objective. To compare brain temperature and cerebral blood flow (CBF) during head and body cooling, with and without systemic hypoxemia. Methods. Seventeen newborn swine were studied for either measurement of brain temperature alone (n = 9) or measurement of brain temperature and CBF (n = 8). All animals were ventilated and instrumented, and temperature probes were inserted into the rectum, into the brain at depths of 2 and 1 cm from the cortical surface, and on the dural surface. Blood flow was measured with microspheres. The protocol consisted of a control period, an interval of either head or body cooling, and cooling with 15 minutes of superimposed hypoxia. After a 1-hour recovery period, animals were exposed to the same sequence except that the alternate mode of cooling was evaluated. Results. Head cooling with a constant rectal temperature resulted in an increase in the temperature gradient across the brain from the warmer central structures to the cooler periphery (brain 2 cm - dura temperature: 1.3 ± 1.1°C at control to 7.5 ± 3.5°C during cooling). Hypoxia superimposed on head cooling decreased the temperature gradient by at least 50{\%}. In contrast, body cooling was associated with an unchanged temperature gradient across the brain (brain 2 cm - dura temperature: 1.5 ± 1.2°C at control to 1.1 ± 0.9°C during cooling). Hypoxia superimposed on body cooling did not change brain temperature. Both modes of brain cooling resulted in similar reductions of global CBF (∼40{\%}) and O2 uptake. Conclusion. Brain hypothermia achieved through head or body cooling results in different brain temperature gradients. Alterations in systemic variables (ie, hypoxemia) alters brain temperature differently in these 2 modes of brain cooling. The mode of brain cooling may affect the efficacy of modest hypothermia as a neuroprotective therapy.",
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N2 - Objective. To compare brain temperature and cerebral blood flow (CBF) during head and body cooling, with and without systemic hypoxemia. Methods. Seventeen newborn swine were studied for either measurement of brain temperature alone (n = 9) or measurement of brain temperature and CBF (n = 8). All animals were ventilated and instrumented, and temperature probes were inserted into the rectum, into the brain at depths of 2 and 1 cm from the cortical surface, and on the dural surface. Blood flow was measured with microspheres. The protocol consisted of a control period, an interval of either head or body cooling, and cooling with 15 minutes of superimposed hypoxia. After a 1-hour recovery period, animals were exposed to the same sequence except that the alternate mode of cooling was evaluated. Results. Head cooling with a constant rectal temperature resulted in an increase in the temperature gradient across the brain from the warmer central structures to the cooler periphery (brain 2 cm - dura temperature: 1.3 ± 1.1°C at control to 7.5 ± 3.5°C during cooling). Hypoxia superimposed on head cooling decreased the temperature gradient by at least 50%. In contrast, body cooling was associated with an unchanged temperature gradient across the brain (brain 2 cm - dura temperature: 1.5 ± 1.2°C at control to 1.1 ± 0.9°C during cooling). Hypoxia superimposed on body cooling did not change brain temperature. Both modes of brain cooling resulted in similar reductions of global CBF (∼40%) and O2 uptake. Conclusion. Brain hypothermia achieved through head or body cooling results in different brain temperature gradients. Alterations in systemic variables (ie, hypoxemia) alters brain temperature differently in these 2 modes of brain cooling. The mode of brain cooling may affect the efficacy of modest hypothermia as a neuroprotective therapy.

AB - Objective. To compare brain temperature and cerebral blood flow (CBF) during head and body cooling, with and without systemic hypoxemia. Methods. Seventeen newborn swine were studied for either measurement of brain temperature alone (n = 9) or measurement of brain temperature and CBF (n = 8). All animals were ventilated and instrumented, and temperature probes were inserted into the rectum, into the brain at depths of 2 and 1 cm from the cortical surface, and on the dural surface. Blood flow was measured with microspheres. The protocol consisted of a control period, an interval of either head or body cooling, and cooling with 15 minutes of superimposed hypoxia. After a 1-hour recovery period, animals were exposed to the same sequence except that the alternate mode of cooling was evaluated. Results. Head cooling with a constant rectal temperature resulted in an increase in the temperature gradient across the brain from the warmer central structures to the cooler periphery (brain 2 cm - dura temperature: 1.3 ± 1.1°C at control to 7.5 ± 3.5°C during cooling). Hypoxia superimposed on head cooling decreased the temperature gradient by at least 50%. In contrast, body cooling was associated with an unchanged temperature gradient across the brain (brain 2 cm - dura temperature: 1.5 ± 1.2°C at control to 1.1 ± 0.9°C during cooling). Hypoxia superimposed on body cooling did not change brain temperature. Both modes of brain cooling resulted in similar reductions of global CBF (∼40%) and O2 uptake. Conclusion. Brain hypothermia achieved through head or body cooling results in different brain temperature gradients. Alterations in systemic variables (ie, hypoxemia) alters brain temperature differently in these 2 modes of brain cooling. The mode of brain cooling may affect the efficacy of modest hypothermia as a neuroprotective therapy.

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