Butterworth R F
Neuroscience Research Unit, CHUM H pital Saint-Luc, Montreal, Québec, Canada.
J Hepatobiliary Pancreat Surg. 2001;8(1):16-9. doi: 10.1007/s005340170046.
Mild hypothermia prevents the development of brain edema in rats with acute liver failure resulting from hepatic devascularization. Mechanistic studies performed in this model suggest that the protective effect of hypothermia results from the inhibition of blood-brain transfer of ammonia, an action which could result (at least in part) from an effect on cerebral blood flow. Hypothermia-induced reductions of brain ammonia are associated with normalization of extracellular brain glutamate concentrations in rats with acute liver failure. Studies in humans suggest that mild hypothermia is beneficial in the management of severely raised intracranial pressure, both before and after liver transplantation in patients with acute liver failure due to acetaminophen overdose. Mild hypothermia offers a potentially useful bridge therapy in patients with acute liver failure who are awaiting liver transplantation.
轻度低温可预防肝血管离断所致急性肝衰竭大鼠脑水肿的发生。在此模型中进行的机制研究表明，低温的保护作用源于对氨血脑转运的抑制，这种作用（至少部分）可能是对脑血流量产生影响的结果。低温诱导的脑氨减少与急性肝衰竭大鼠脑内细胞外谷氨酸浓度的正常化有关。对人类的研究表明，轻度低温对于对乙酰氨基酚过量所致急性肝衰竭患者在肝移植前后严重升高的颅内压的管理是有益的。轻度低温为等待肝移植的急性肝衰竭患者提供了一种潜在有用的过渡治疗方法。
