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Targeted temperature management (TTM), previously known as therapeutic hypothermia or protective hypothermia, is an active treatment that tries to achieve and maintain a specific body temperature in a person for a specific duration of time in an effort to improve health outcomes during recovery after a period of stopped blood flow to the brain. [1]
Simplified control circuit of human thermoregulation. [8]The core temperature of a human is regulated and stabilized primarily by the hypothalamus, a region of the brain linking the endocrine system to the nervous system, [9] and more specifically by the anterior hypothalamic nucleus and the adjacent preoptic area regions of the hypothalamus.
When ambient temperature is excessive, humans and many other animals cool themselves below ambient by evaporative cooling of sweat (or other aqueous liquid; saliva in dogs, for example); this helps prevent potentially fatal hyperthermia. The effectiveness of evaporative cooling depends upon humidity.
Sweating causes a decrease in core temperature through evaporative cooling at the skin surface. As high energy molecules evaporate from the skin, releasing energy absorbed from the body, the skin and superficial vessels decrease in temperature. Cooled venous blood then returns to the body's core and counteracts rising core temperatures.
Evaporation of water, either across respiratory surfaces or across the skin in those animals possessing sweat glands, helps in cooling body temperature to within the organism's tolerance range. Animals with a body covered by fur have limited ability to sweat, relying heavily on panting to increase evaporation of water across the moist surfaces ...
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Treatment of heat stroke involves rapid mechanical cooling along with standard resuscitation measures. [22] The body temperature must be lowered quickly via conduction, convection, or evaporation. [4] During cooling, the body temperature should be lowered to less than 39 degrees Celsius, ideally less than 38-38.5 degrees Celsius. [5]
During open surgery the surgeon exposes the peritoneal cavity to the ambient air. Exposure to ambient air results in evaporation and cooling. Current studies have shown that the use of surgical humidification during open abdominal surgery (laparotomy) have warmer core body temperatures and reduced risk of operative hypothermia.
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