Alzaga Ana G, Cerdan Mario, Varon Joseph
Universidad Autónoma de Tamaulipas, Tampico, Mexico.
Resuscitation. 2006 Sep;70(3):369-80. doi: 10.1016/j.resuscitation.2006.01.017. Epub 2006 Aug 22.
Therapeutic hypothermia has been used for millennia, but in recent years was not in much clinical use due to an apparent high risk of complications. More recently, the benefits of induced therapeutic hypothermia have been rediscovered, mainly with the improvement in neurological outcome in out-of-hospital cardiac arrest victims. In addition, therapeutic hypothermia has been suggested to improve outcome in other neurological conditions such as traumatic brain injury, neonatal asphyxia, cerebrovascular accidents and intracranial hypertension. This article reviews the history of the discovery of therapeutic hypothermia, as well as the current therapeutic applications and ways to deliver this treatment. Cooling techniques and recovery processes, as well as potential complications are also reviewed. Clinicians caring for a wide variety of critically ill patients should be familiar with the use of therapeutic hypothermia.
治疗性低温已经使用了数千年,但近年来由于明显的高并发症风险而未得到广泛临床应用。最近,诱导性治疗性低温的益处被重新发现,主要体现在院外心脏骤停患者神经功能结局的改善上。此外,有人提出治疗性低温可改善其他神经系统疾病的结局,如创伤性脑损伤、新生儿窒息、脑血管意外和颅内高压。本文回顾了治疗性低温的发现历史,以及当前的治疗应用和实施该治疗的方法。还回顾了降温技术、恢复过程以及潜在并发症。照顾各种重症患者的临床医生应熟悉治疗性低温的使用。