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Anesthesiology Aug 2008Most clinically available thermometers accurately report the temperature of whatever tissue is being measured. The difficulty is that no reliably... (Review)
Review
Most clinically available thermometers accurately report the temperature of whatever tissue is being measured. The difficulty is that no reliably core-temperature-measuring sites are completely noninvasive and easy to use-especially in patients not undergoing general anesthesia. Nonetheless, temperature can be reliably measured in most patients. Body temperature should be measured in patients undergoing general anesthesia exceeding 30 min in duration and in patients undergoing major operations during neuraxial anesthesia. Core body temperature is normally tightly regulated. All general anesthetics produce a profound dose-dependent reduction in the core temperature, triggering cold defenses, including arteriovenous shunt vasoconstriction and shivering. Anesthetic-induced impairment of normal thermoregulatory control, with the resulting core-to-peripheral redistribution of body heat, is the primary cause of hypothermia in most patients. Neuraxial anesthesia also impairs thermoregulatory control, although to a lesser extent than does general anesthesia. Prolonged epidural analgesia is associated with hyperthermia whose cause remains unknown.
Topics: Anesthesia, General; Body Temperature; Body Temperature Regulation; Humans; Hypothermia; Monitoring, Intraoperative; Shivering; Skin Temperature; Sweating
PubMed: 18648241
DOI: 10.1097/ALN.0b013e31817f6d76 -
Annals of the Academy of Medicine,... Apr 2008This review discusses human thermoregulation during exercise and the measurement of body temperature in clinical and exercise settings. The thermoregulatory mechanisms... (Review)
Review
This review discusses human thermoregulation during exercise and the measurement of body temperature in clinical and exercise settings. The thermoregulatory mechanisms play important roles in maintaining physiological homeostasis during rest and physical exercise. Physical exertion poses a challenge to thermoregulation by causing a substantial increase in metabolic heat production. However, within a non-thermolytic range, the thermoregulatory mechanisms are capable of adapting to sustain physiological functions under these conditions. The central nervous system may also rely on hyperthermia to protect the body from "overheating." Hyperthermia may serve as a self-limiting signal that triggers central inhibition of exercise performance when a temperature threshold is achieved. Exposure to sub-lethal heat stress may also confer tolerance against higher doses of heat stress by inducing the production of heat shock proteins, which protect cells against the thermolytic effects of heat. Advances in body temperature measurement also contribute to research in thermoregulation. Current evidence supports the use of oral temperature measurement in the clinical setting, although it may not be as convenient as tympanic temperature measurement using the infrared temperature scanner. Rectal and oesophagus temperatures are widely accepted surrogate measurements of core temperature (Tc), but they cause discomfort and are less likely to be accepted by users. Gastrointestinal temperature measurement using the ingestible temperature sensor provides an acceptable level of accuracy as a surrogate measure of Tc without causing discomfort to the user. This form of Tc measurement also allows Tc to be measured continuously in the field and has gained wider acceptance in the last decade.
Topics: Body Temperature; Body Temperature Regulation; Exercise; Humans; Monitoring, Physiologic
PubMed: 18461221
DOI: No ID Found -
Neuron Apr 2018The regulation of body temperature is one of the most critical functions of the nervous system. Here we review our current understanding of thermoregulation in mammals.... (Review)
Review
The regulation of body temperature is one of the most critical functions of the nervous system. Here we review our current understanding of thermoregulation in mammals. We outline the molecules and cells that measure body temperature in the periphery, the neural pathways that communicate this information to the brain, and the central circuits that coordinate the homeostatic response. We also discuss some of the key unresolved issues in this field, including the following: the role of temperature sensing in the brain, the molecular identity of the warm sensor, the central representation of the labeled line for cold, and the neural substrates of thermoregulatory behavior. We suggest that approaches for molecularly defined circuit analysis will provide new insight into these topics in the near future.
Topics: Animals; Body Temperature; Body Temperature Regulation; Brain; Homeostasis; Humans; Neural Pathways; Thermosensing
PubMed: 29621489
DOI: 10.1016/j.neuron.2018.02.022 -
Autonomic Neuroscience : Basic &... Apr 2016Thermoregulation is a vital function of the autonomic nervous system in response to cold and heat stress. Thermoregulatory physiology sustains health by keeping body... (Review)
Review
Thermoregulation is a vital function of the autonomic nervous system in response to cold and heat stress. Thermoregulatory physiology sustains health by keeping body core temperature within a degree or two of 37°C, which enables normal cellular function. Heat production and dissipation are dependent on a coordinated set of autonomic responses. The clinical detection of thermoregulatory impairment provides important diagnostic and localizing information in the evaluation of disorders that impair thermoregulatory pathways, including autonomic neuropathies and ganglionopathies. Failure of neural thermoregulatory mechanisms or exposure to extreme or sustained temperatures that overwhelm the body's thermoregulatory capacity can also result in potentially life-threatening departures from normothermia. Hypothermia, defined as a core temperature of <35.0°C, may present with shivering, respiratory depression, cardiac dysrhythmias, impaired mental function, mydriasis, hypotension, and muscle dysfunction, which can progress to cardiac arrest or coma. Management includes warming measures, hydration, and cardiovascular support. Deaths from hypothermia are twice as frequent as deaths from hyperthermia. Hyperthermia, defined as a core temperature of >40.5°C, may present with sweating, flushing, tachycardia, fatigue, lightheadedness, headache, and paresthesia, progressing to weakness, muscle cramps, oliguria, nausea, agitation, hypotension, syncope, confusion, delirium, seizures, and coma. Mental status changes and core temperature distinguish potentially fatal heat stroke from heat exhaustion. Management requires the immediate reduction of core temperature. Ice water immersion has been shown to be superior to alternative cooling measures. Avoidance of thermal risk and early recognition of cold or heat stress are the cornerstones of preventive therapy.
Topics: Animals; Body Temperature; Body Temperature Regulation; Cold Temperature; Fever; Hot Temperature; Humans; Hypothermia
PubMed: 26794588
DOI: 10.1016/j.autneu.2016.01.001 -
Anesthesiology Jan 2013Although suppression of thermoregulatory mechanisms by anesthetics is generally assumed, the extent to which thermoregulation is active during general anesthesia is not...
Although suppression of thermoregulatory mechanisms by anesthetics is generally assumed, the extent to which thermoregulation is active during general anesthesia is not known. The only thermoregulatory responses available to anesthetized, hypothermic patients are vasoconstriction and nonshivering thermogenesis. To test anesthetic effects on thermoregulation, the authors measured skin-surface temperature gradients (forearm temperature - fingertip temperature) as an index of cutaneous vasoconstriction in unpremedicated patients anesthetized with 1% halothane and paralyzed with vecuronium during elective, donor nephrectomy. Patients were randomly assigned to undergo maximal warming (warm room, humidified respiratory gases, and warm intravenous fluids; n = 5) or standard temperature management (no special warming measures; n = 5). Skin-surface temperature gradients of 4°C or more were prospectively defined as significant vasoconstriction. Normothermic patients (average minimum esophageal temperature = 36.4° ± 0.3°C [SD]) did not demonstrate significant vasoconstriction. However, each hypothermic patient displayed significant vasoconstriction at esophageal temperatures ranging from 34.0 to 34.8°C (average temperature = 34.4° ± 0.2°C). These data indicate that active thermoregulation occurs during halothane anesthesia, but that it does not occur until core temperature is approximately 2.5°C lower than normal. In two additional hypothermic patients, increased skin-temperature gradients correlated with decreased perfusion as measured by a laser Doppler technique. Measuring skin-surface temperature gradients is a simple, noninvasive, and quantitative method of determining the thermoregulatory threshold during anesthesia.
Topics: Anesthesia, Inhalation; Body Temperature Regulation; Halothane; Humans
PubMed: 23221865
DOI: 10.1097/ALN.0b013e3182784df3 -
Autonomic Neuroscience : Basic &... Apr 2016Sufficient body water is required to sustain thermoregulatory function, thus losses in total body water (TBW) can challenge the thermoregulatory system. A TBW deficit... (Review)
Review
Sufficient body water is required to sustain thermoregulatory function, thus losses in total body water (TBW) can challenge the thermoregulatory system. A TBW deficit ≥2% body mass (hypohydration) is recognized as the threshold when thermoregulatory function becomes measurably altered. Hypohydration may occur from voluntary fluid restriction, insufficient fluid availability, or thermoregulatory sweating. The secretion and evaporation of sweat important avenues of body heat loss, and if the water lost is not replaced, hypohydration will decrease plasma volume and increase plasma osmotic pressure (hyperosmotic hypovolemia). Both osmotic and/or volume stressors delay the onset and/or reduce the sensitivity of sweating and blood flow responses. The magnitude of hypohydration, environmental heat stress, the population and circumstances of interest will determine the degree, significance and outcome of these thermoregulatory alterations and their contribution to physiological stress.
Topics: Animals; Body Temperature Regulation; Body Water; Exercise; Hot Temperature; Humans; Skin Temperature; Sweating
PubMed: 26944095
DOI: 10.1016/j.autneu.2016.02.003 -
Journal of the American Association For... Sep 2022Noninvasive blood pressure measurement devices have gained popularity in recent years as an alternative to radiotelemetry and other invasive blood pressure measurement...
Noninvasive blood pressure measurement devices have gained popularity in recent years as an alternative to radiotelemetry and other invasive blood pressure measurement techniques. While many factors must be considered when choosing a measurement method, specific variables should be evaluated when using a tail-cuff blood pressure technique. Rodents have complex and dynamic thermal biology processes that involve fluctuating vasomotor tone of the tail. This and other factors that affect vascular tone, such as the autonomic response to stress, significantly affect peripheral blood flow. Awareness and consideration of thermoregulatory states and vasomotor tone can increase success and decrease variability when measuring blood pressure measurements using a tail-cuff measurement technique.
Topics: Animals; Blood Pressure; Blood Pressure Determination; Body Temperature Regulation; Rodentia; Tail
PubMed: 35948400
DOI: 10.30802/AALAS-JAALAS-22-000006 -
The Journal of Experimental Biology Feb 2022Ectothermic vertebrates use a suite of physiological and behavioral mechanisms to thermoregulate, which result in various thermoregulatory strategies from...
Ectothermic vertebrates use a suite of physiological and behavioral mechanisms to thermoregulate, which result in various thermoregulatory strategies from thermoconformity to thermoregulation. Here, we present a novel synthesis of theoretical and empirical methods to determine cardiovascular contributions to heat transfer in free-living ectothermic vertebrates. We start by identifying the fundamental components of heat transfer and the cardiovascular mechanisms for physiological modulation of heat exchange, and then integrate these components into a single, integrative framework: the cardiovascular heat exchange framework (CHEF). We demonstrate that this framework can identify details of the thermoregulatory strategy in two turtle species, most notably the preponderance of instances where turtles use physiological mechanisms to avoid overheating, suggesting vulnerability to climate change. As modulated physiological contributions to heat flow incur a greater energy demand than relying on unmodulated passive heat transfer, we then asked whether we could characterize the energetic costs of thermoregulation. We measured field metabolic rate (FMR) in free-living turtles and used the CHEF to determine FMR while actively or passively thermoregulating. Comparing an individual's actual FMR to the rate calculated assuming absence of thermoregulation revealed that painted turtles, a partial thermoregulator, elevate their daily energy expenditure (DEE) by about 25%, while box turtles, a thermoconformer, have a DEE that is nearly unchanged as a result of thermoregulation. This integrative framework builds a new paradigm that provides a mechanism to explain correlations between energy demand and thermoregulatory strategy, quantifies the energetic costs of thermoregulation, and identifies the role of cardiovascular contributions to thermoregulation in free-living animals.
Topics: Animals; Body Temperature Regulation; Hot Temperature; Turtles
PubMed: 35119074
DOI: 10.1242/jeb.243095 -
Physiological Reports Sep 2023The cardiovascular system is primarily controlled by the autonomic nervous system, and any changes in sympathetic or parasympathetic activity also have an impact on... (Review)
Review
The cardiovascular system is primarily controlled by the autonomic nervous system, and any changes in sympathetic or parasympathetic activity also have an impact on myocardial activity. Heart rate variability (HRV) is a readily available metric used to assess heart rate control by the autonomic nervous system. HRV can provide information about neural (parasympathetic, sympathetic, reflex) and humoral (hormones, thermoregulation) control of myocardial activity. Because there are no relevant reference values for HRV parameters in rats in the scientific literature, all experimental results are only interpreted on the basis of changes from currently measured control or baseline HRV values, which are, however, significantly different in individual studies. Considering the significant variability of published HRV data, the present study focused primarily on comparing control or baseline HRV values under different conditions in in vivo experiments involving rats. The aim of the study was therefore to assess whether there are differences in the starting values before the experiment itself.
Topics: Male; Animals; Rats; Heart Rate; Autonomic Nervous System; Body Temperature Regulation; Myocardium; Reference Values
PubMed: 37735345
DOI: 10.14814/phy2.15827 -
Journal of Thermal Biology Feb 2023Severe thermal discomfort may increase risk of drowning due to hypothermia or hyperthermia from prolonged exposure to noxious water temperatures. The importance of using... (Review)
Review
BACKGROUND
Severe thermal discomfort may increase risk of drowning due to hypothermia or hyperthermia from prolonged exposure to noxious water temperatures. The importance of using a behavioral thermoregulation model with thermal sensation may predict the thermal load that the human body receives when exposed to various immersive water conditions. However, there is no thermal sensation "gold standard" model specific for water immersion. This scoping review aims to present a comprehensive overview regarding human physiological and behavioral thermoregulation during whole-body water immersion and explore the feasibility for an accepted defined sensation scale for cold and hot water immersion.
METHODS
A standard literary search was performed on PubMed, Google Scholar, and SCOPUS. The words "Water Immersion," "Thermoregulation," "Cardiovascular responses" were used either as independent searched terms and MeSH terms (Medical Subject Headings) or in combination with other text words. The inclusion criteria for clinical trials terms to thermoregulatory measurements (core or skin temperature), whole-body immersion, 18-60 years old and healthy individuals. The prementioned data were analyzed narratively to achieve the overall study objective.
RESULTS
Twenty-three published articles fulfilled the review inclusion/exclusion criteria (with nine measured behavioral responses). Our outcomes illustrated a homogenous thermal sensation in a variety of water temperatures ranges, that was strongly associated with thermal balance, and observed different thermoregulatory responses. This scoping review highlights the impact of water immersion duration on human thermoneutral zone, thermal comfort zone, and thermal sensation.
CONCLUSION
Our findings enlighten the significance of thermal sensation as a health indicator for establishing a behavioral thermal model applicable for water immersion. This scoping review provides insight for the needed development of subjective thermal model of thermal sensation in relation to human thermal physiology specific to immersive water temperature ranges within and outside the thermal neutral and comfort zone.
Topics: Humans; Adolescent; Young Adult; Adult; Middle Aged; Temperature; Water; Immersion; Body Temperature Regulation; Thermosensing; Cold Temperature; Skin Temperature
PubMed: 36796887
DOI: 10.1016/j.jtherbio.2022.103430