Polderman Kees H, Callaghan Jeannie
Department of Intensive Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Crit Care. 2006;10(6):234. doi: 10.1186/cc5023.
There is growing acceptance within the medical community of induced (therapeutic) hypothermia as a tool to achieve neuroprotection and/or cardioprotection. Although much work remains to be done in identifying those clinical situations in which hypothermia can be effective, there is now sufficient evidence to regard it as a standard of care, at least for some indications such as selected patients with postanoxic encephalopathy. Thus, attention is now partly shifting from assessment of the clinical evidence of efficacy to technical and implementation issues. This review provides a list of criteria by which cooling devices can be judged, and specifically it discusses one of the new cooling devices: the Alsius CoolGard 3000 device and CoolLine catheter. General aspects and advantages/disadvantages of surface versus core cooling are discussed, as are potential side effects, device-specific pros and cons, and cost-effectiveness issues. In addition, the current state of the evidence for use of induced hypothermia for various indications is briefly reviewed.
在医学界，诱导（治疗性）低温作为实现神经保护和/或心脏保护的一种手段正越来越被接受。尽管在确定低温可发挥作用的临床情况方面仍有许多工作要做，但现在有足够的证据将其视为一种护理标准，至少对于某些适应症，如选定的缺氧后脑病患者。因此，目前部分注意力正从疗效的临床证据评估转向技术和实施问题。本综述提供了一系列可据此评判冷却设备的标准，具体讨论了一种新型冷却设备：Alsius CoolGard 3000设备和CoolLine导管。讨论了体表冷却与核心冷却的一般方面和优缺点，以及潜在的副作用、特定设备的优缺点和成本效益问题。此外，还简要回顾了诱导低温用于各种适应症的现有证据状况。
