Inamasu Joji, Ichikizaki Kiyoshi
Department of Emergency Medicine, National Tokyo Medical Center, Tokyo, Japan.
Ann Emerg Med. 2002 Aug;40(2):220-30. doi: 10.1067/mem.2002.123697.
Induced hypothermia to treat various neurologic emergencies, which had initially been introduced into clinical practice in the 1940s and 1950s, had become obsolete by the 1980s. In the early 1990s, however, it made a comeback in the treatment of severe traumatic brain injury. The success of mild hypothermia led to the broadening of its application to many other neurologic emergencies. We sought to summarize recent developments in mild hypothermia, as well as its therapeutic potential and limitations. Mild hypothermia has been applied with varying degrees of success in many neurologic emergencies, including traumatic brain injury, spinal cord injury, ischemic stroke, subarachnoid hemorrhage, out-of-hospital cardiopulmonary arrest, hepatic encephalopathy, perinatal asphyxia (hypoxic-anoxic encephalopathy), and infantile viral encephalopathy. At present, the efficacy and safety of mild hypothermia remain unproved. Although the preliminary clinical studies have shown that mild hypothermia can be a feasible and relatively safe treatment, multicenter randomized, controlled trials are warranted to define the indications for induced hypothermia in an evidence-based fashion.
诱导低温疗法用于治疗各种神经系统急症，该疗法最初在20世纪40年代和50年代被引入临床实践，但到20世纪80年代已过时。然而，在20世纪90年代初，它在严重创伤性脑损伤的治疗中卷土重来。轻度低温疗法的成功促使其应用范围扩大到许多其他神经系统急症。我们试图总结轻度低温疗法的最新进展及其治疗潜力和局限性。轻度低温疗法在许多神经系统急症中已得到不同程度的应用，包括创伤性脑损伤、脊髓损伤、缺血性中风、蛛网膜下腔出血、院外心脏骤停、肝性脑病、围产期窒息（缺氧缺血性脑病）和婴儿病毒性脑病。目前，轻度低温疗法的疗效和安全性尚未得到证实。尽管初步临床研究表明轻度低温疗法可能是一种可行且相对安全的治疗方法，但仍需要多中心随机对照试验以循证方式确定诱导低温疗法的适应证。
