Jugular Bulb Temperature Research Articles

Jugular bulb temperature: comparison with brain surface and core temperatures in neurosurgical patients during mild hypothermia.

Blood temperature at the jugular bulb was monitored in 10 patients undergoing neurovascular procedures that used induced mild hypothermia, and its correlation with surface brain, core, and peripheral temperatures was determined. The study was motivated by the difficulty encountered in directly measuring global brain temperature and the poor correlations between various core and peripheral sites temperatures and brain temperature, particularly during deep hypothermia. Although not statistically significant, previous studies have suggested a trend toward higher brain temperatures. Temperatures from the jugular bulb (collected using a No. 5 French Swan-Ganz catheter) as well as from subdural, pulmonary artery, esophagus, tympanic membrane, and bladder sites were analyzed during three surgical conditions: prior to incision, with the dura open, and after closure of the dura. No complications related to placement of the jugular bulb catheter, induced hypothermia, or temperature monitoring were seen. The authors found that jugular bulb temperature was similar to pulmonary artery and esophageal temperatures; although prior to incision it tended to be higher than that found at the pulmonary artery, most commonly by 0.2 degrees C. Surface brain temperature was cooler than all other temperatures (p < 0.05), except that of the tympanic membrane, and was particularly sensitive to environmental variations. Finally, as has been shown by others, bladder temperature lagged substantially behind core temperatures particularly during rapid cooling and rewarming of the patient. In summary, monitoring of jugular bulb temperature is a feasible technique, and temperatures measured in the jugular bulb are similar to core temperatures.

Annual meeting of the Society of Neurosurgical Anesthesia and Critical Care. Atlanta, Georgia, October 20, 1995.

Annual meeting of the Society of Neurosurgical Anesthesia and Critical Care. Atlanta, Georgia, October 20, 1995.

Cerebral hyperthermia during cardiopulmonary bypass in adults

Accepted for publication June 7, 1995 In this report, we document that cerebral hyperthermia occurs regularly during rewarming from hypothermic cardiopulmonary bypass (CPB). These high brain temperatures are not adequately reflected by nasopharyngeal (NP) temperature and may contribute to neurologic morbidity. Stroke and neurocognitive injury remain significant components of perioperative morbidity associated with cardiac surgery. Hypothermic CPB is used in part for its cerebral protective effects. Recent reports, however, have indicated that the rewarming phase of hypothermic CPB is associated with a significant incidence of decreased cerebral venous oxygen saturation (Sjvo2; 50%). 1,2 Sjvo2 is thought to be a general index of the adequacy of the matching of cerebral oxygen supply with demand.

Sweating, hemodynamic responses, and thermal equilibration during hyperthermia in humans.

Hyperthermia, to 42 degrees C, for treatment of cancer, was induced 23 times in 13 anesthetized patients utilizing an extracorporeal heat-exchange circuit. Sweating rate over the chest, abdomen, arm and forearm ranged from 0.2 to 0.9 mg sweat X min-1 X cm-2. Cardiac index (CI), stroke volume index (SVI), left ventricular stroke work index, and right ventricular stroke work index initially increased to 221 +/- 12.5, 162 +/- 9.6, 142 +/- 11, and 203 +/- 29% but later fell to 169-173, 113-120, 69, and 148-117% of control, respectively. Heart rate initially rose to 145 +/- 5.9% and then stabilized at 160-162% of control. Pulmonary arterial occlusion pressure and central venous pressure initially fell to 82 +/- 8 and 93 +/- 9% but later rose to 87-102 and 105-120% of control levels, respectively. The hemodynamic response to severe heat stress in anesthetized humans was characterized by peripheral vasodilation accompanied by compensatory increases in heart rate and CI. Ventricular function, as reflected by SVI and CI, declined with continued heat stress, despite reduced afterload and stable or increased filling pressures. Pulmonary arterial temperature rose fastest, followed by the esophageal, rectal, and bladder temperatures, respectively. Jugular bulb temperature also rose rapidly.