Friberg Hans, Herlitz Johan, Rubertsson Sten, Wieloch Tadeusz
Anestesi- och intensivvårdskliniken, Universitetssjukhuset i Lund, Sweden.
Lakartidningen. 2004 Jul 22;101(30-31):2412-6.
Sudden, unexpected cardiac arrest is a common cause of death. Among patients who are successfully resuscitated, a majority dies without regaining consciousness. Therapeutic hypothermia has recently been shown to improve neurological outcome in two randomized studies and to improve survival in one of them. Based on the two studies, international evidence-based recommendations have been proposed and published (ILCOR). In this review we discuss the theoretical background of hypothermic neuroprotection and therapeutic implications. We propose that victims of cardiac arrest with return of spontaneous circulation and persistent unconsciousness are considered for hypothermia treatment and that data from treated patients are collected in a common website database (see: www.scctg.org) to allow further evaluation of the use of ICU resources, efficacy of hypothermia treatment and potential risks.
突发、意外心脏骤停是常见的死亡原因。在成功复苏的患者中，大多数人死亡时未恢复意识。最近的两项随机研究表明，治疗性低温可改善神经功能结局，其中一项研究还显示可提高生存率。基于这两项研究，已提出并发布了国际循证建议（国际复苏联络委员会）。在本综述中，我们讨论低温神经保护的理论背景及其治疗意义。我们建议，对于心脏骤停后恢复自主循环但仍持续昏迷的患者，应考虑进行低温治疗，并将接受治疗患者的数据收集到一个通用的网站数据库中（见：www.scctg.org），以便进一步评估重症监护病房资源的使用情况、低温治疗的疗效及潜在风险。
