Head and neck cooling after cardiac arrest results in lower jugular bulb than esophageal temperature

Am J Emerg Med. 2009 May;27(4):460-5. doi: 10.1016/j.ajem.2008.03.036.

Abstract

Purpose: To determine whether during the initial phase of head and neck cooling, jugular bulb temperature (Tjb; which may reflect brain temperature) is lower than esophageal temperature (Tes).

Basic procedures: To compare Tes and Tjb, patients received head or head and neck cooling after cardiac arrest.

Main findings: The first series with head cooling (n = 5; mean age 54 with a range of 41-62 years; 1 female and 4 males; mean body weight 80 kg with a range of 70-85 kg) showed a mean difference of 0.22 degrees C (95% CI, -1.14 to 0.70; P = .55; limits of agreement, -3.17 to 2.73) between Tes and Tjb over 12 hours. For the second series, with head and neck cooling (n = 6, mean age 65 with a range of 56-76 years; 3 females and 3 males; mean body weight 75 kg with a range of 65-91 kg), Tjb was lower than Tes with a difference of 0.60 degrees C (95% CI, 0.22 to 0.99; P = .01; limits of agreement, -3.10 to 4.30). During the first 3 hours, Tjb decreased faster than Tes (1.1 degrees C/h [95% CI, 0.4 to 1.8; P < .01]).

Principal conclusion: During the initial phase of therapeutic hypothermia, Tjb seems to be lower than Tes.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Body Temperature / physiology*
  • Brain / physiology*
  • Esophagus / physiology
  • Female
  • Head
  • Heart Arrest / therapy*
  • Humans
  • Hypothermia, Induced / instrumentation
  • Hypothermia, Induced / methods*
  • Jugular Veins / physiology
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods*
  • Neck
  • Tympanic Membrane / physiology