Vigué B, Geeraerts T, Le Guen M, Engrand N, Ract C
Département d'Anesthésie-Réanimation, CHU de Bicêtre, 94275 Le-Kremlin-Bicêtre, France.
Ann Fr Anesth Reanim. 2006 Aug;25(8):838-44. doi: 10.1016/j.annfar.2006.03.017. Epub 2006 May 3.
The benefit of therapeutic hypothermia after severe head injury is highly controversial. However, hypothermia is still used and studied in this context for multiple reasons. Efficacy of hypothermia is demonstrated after cerebral ischemia in numerous animal studies and after cardiac arrest in human studies. Hyperthermia is a major independent factor of outcome after cerebral ischemic or traumatic brain injury. Moreover, ICP is related to core temperature, and hypothermia may be used to decrease intracranial hypertension. However, many questions are still unresolved and can explain discrepancies between clinical studies: direct measurement of cerebral temperature, relationship between ICP, temperature and PaCO(2), level and duration of hypothermia and precise methods for cooling and particularly for rewarming.
严重颅脑损伤后治疗性低温的益处极具争议。然而，出于多种原因，低温仍在此背景下被应用和研究。在众多动物研究中的脑缺血后以及人体研究中的心脏骤停后，低温的疗效得到了证实。高温是脑缺血或创伤性脑损伤后预后的一个主要独立因素。此外，颅内压与核心体温相关，低温可用于降低颅内高压。然而，许多问题仍未解决，这也能解释临床研究之间的差异：脑温的直接测量、颅内压、体温与动脉血二氧化碳分压之间的关系、低温的程度和持续时间以及精确的降温方法，尤其是复温方法。
