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

Overview

Kristijan Skok, Maja Duh, Andraž Stožer, Andrej Markota, Marko Gosak

Published Online: Nov 29 2020

DOI: 10.1002/wsbm.1513

Full article on Wiley Online Library: HTML PDF

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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 > Cardiovascular Diseases>Computational Models Cardiovascular Diseases > Cardiovascular Diseases>Environmental Factors Cardiovascular Diseases > Cardiovascular Diseases>Biomedical Engineering

Division of thermoregulatory modes. Legend: Coloring scheme: blue—thermoconformers; red—thermoregulators. Summarized after Willmer et al. (2005)

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A schematic representation of a thermophysiological model for predicting human thermal and regulatory responses. Each cylindrical segment is divided into four nodes of core, skin, arterial, and venous blood. Individual segments are connected through blood flow in the arteries and veins to account for the distribution of heat between body parts. Within individual segments, heat is transferred between nodes by perfusion (1), convection (2), and conduction (3). Heat within the core is generated by basal metabolic processes, mechanical work and shivering, when needed. Besides the later, vasoconstriction, vasodilation and sweating are other active processes that keep the body in thermal balance with respect to the heat exchange with the environment. For further explanation, see references Enescu (2019), Fu et al. (2016) and Katić et al. (2016), and references therein

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