Georgiadis D, Schwarz S, Kollmar R, Schwab S
Department of Neurology, University of Heidelberg, Germany.
Stroke. 2001 Nov;32(11):2550-3. doi: 10.1161/hs1101.097382.
We undertook this study to evaluate the feasibility of inducing and maintaining moderate hypothermia with the use of endovascular rather than surface cooling.
Six patients with severe acute ischemic stroke were treated with moderate hypothermia. This was induced and maintained by circulating temperature-adjusted normal saline in a closed-loop system entailing 3 balloons located near the tip of a central line, which dwelled in the inferior vena cava.
The mean+/-SD initial temperature of the patients was 37+/-1 degrees C (range, 35.5 degrees C to 38.4 degrees C). The pace of cooling was 1.4+/-0.6 degrees C/h, and target temperature was reached after 3+/-1 hours (range, 2 to 4.5 hours). During hypothermia, the maximal temperature observed was 33.4 degrees C, and the minimal temperature was 32.2 degrees C. Temperature deviations >0.2 degrees C or >0.3 degrees C were observed during 21% or 10% of the hours under hypothermia, respectively. Singultus was the only device-related complication encountered. Pulmonary infection, arterial hypotension, bradycardia, arrhythmia, and thrombocytopenia were the most common side effects.
Induction and maintenance of hypothermia with an intravenous cooling device are feasible. The safety of this approach remains to be evaluated.
我们开展这项研究以评估使用血管内降温而非体表降温诱导并维持中度低温的可行性。
6例严重急性缺血性卒中患者接受了中度低温治疗。通过在一个闭环系统中循环温度调节的生理盐水来诱导并维持低温，该系统包含位于中心静脉导管尖端附近、置于下腔静脉的3个球囊。
患者的平均±标准差初始体温为37±1℃（范围为35.5℃至38.4℃）。降温速度为1.4±0.6℃/小时，3±1小时（范围为2至4.5小时）后达到目标温度。低温期间，观察到的最高温度为33.4℃，最低温度为32.2℃。在低温期间，分别有21%或10%的小时数出现温度偏差>0.2℃或>0.3℃。呃逆是唯一遇到的与设备相关的并发症。肺部感染、动脉低血压、心动过缓、心律失常和血小板减少是最常见的副作用。
使用静脉降温设备诱导并维持低温是可行的。这种方法的安全性仍有待评估。
Zotero 插件