Thermoregulation: A journey from physiology to computational models and the intensive care unit

Abstract

Thermoregulation plays a vital role in homeostasis. Many species of animals as well as humans have evolved various physiological mechanisms for body temperature control, which are characteristically flexible and enable a fine‐tuned spatial and temporal regulation of body temperature in different environmental conditions and circumstances. Human beings normally maintain a core body temperature at around 37°C, and maintenance of this relatively high temperature is critical for survival. Therefore, principles of thermoregulatory control have also important clinical implications. Infections can cause the body temperature to rise internally and several diseases can cause a dysfunction of thermoregulatory mechanisms. Moreover, the utilization of thermotherapies in treating various diseases has been known for thousands of years with a recent resurgence of interest. An increasing amount of research suggests that targeted temperature management is of paramount importance to patient outcomes in certain clinical scenarios. We provide a concise summary of the basic concepts of thermoregulation. Emphasis is given to the principles of thermoregulation in humans in basic pathological states and to targeted temperature management strategies in the clinical environment, with special attention on therapeutic hypothermia in postcardiac arrest patients. Finally, the discussion is focused on the potential offered by computational thermophysiological models for predicting thermal responses of patients in various clinical circumstances, for proposing new perspectives in the design of novel thermal therapies, and to optimize targeted temperature management strategies.This article is categorized under: Cardiovascular Diseases > Computational Models Cardiovascular Diseases > Environmental Factors Cardiovascular Diseases > Biomedical Engineering

Better Control of Body Temperature Is Not Associated with Improved Hemodynamic and Respiratory Parameters in Mechanically Ventilated Patients with Sepsis

“…Third, various techniques and devices were used to manage temperature, such as ice pads, surface cooling with automated systems, esophageal cooling, renal replacement therapy, acetaminophen, different sedatives and opiates that interfere with normal temperature responses, etc. These factors could potentially influence our outcomes [ 5 ].…”

“…Traditionally, pyrogenic fever is treated at least with antipyretics and possibly with physical cooling when core body temperature (CBT) reaches around 38–38.5 °C [ 1 ]. The physiological rationale underlying temperature management in critically ill patients with fever (excluding specific patient populations) is mainly based on reduced metabolic demands associated with the reduction in basal metabolism rate after a decrease in CBT [ 5 , 6 ]. Therefore, the majority of temperature management interventions for this patient population are aimed at reducing CBT towards mild hyperthermia or normothermia (i.e., reduction in BT below 38–38.5 °C) [ 1 ].…”

Mechanically Robust, Flexible, Fast Responding Temperature Sensor and High‐Resolution Array with Ionically Conductive Double Cross‐Linked Hydrogel

“…Body temperature is one of the most important indicators to assess the body wellness level, because many diseases either result from thermoregulation failure or result in abnormal temperature. [42,43] Detecting body temperature can help discovering potential health risks, disease diagnosing, and personal health management. [44] Therefore, wearable temperature sensors play significant roles for real-time monitoring body temperature so that local or even global health problems could be noticed and treated in a timely manner.…”

Modelling the Efficacy of Febrile Heating in Infected Endotherms

“…It was not always so: inducing fever as a therapeutic intervention for particular infections was practised in the pre-antibiotic era (Simpson, 1936). ' Abnormal' body temperatures can be a therapeutic target in the management of some critical illnesses (e.g., therapeutic hypothermia in cardiac arrest), and there is a renewed interest in 'thermal therapy' (either localised or systemic) as a possible adjunct treatment for infectious diseases given the challenge of antimicrobial resistance (Gazel and Yılmaz, 2018;Skok et al, 2021).…”