Cushman Lisa, Warren Mary Lou, Livesay Sarah
St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
Crit Care Nurs Q. 2007 Apr-Jun;30(2):143-53. doi: 10.1097/01.CNQ.0000264257.75252.41.
Despite progress in resuscitative practices, there has been little improvement in mortality and neurologic morbidity outcomes after cardiac arrest. Updated resuscitative guidelines were published in 2005, and included changes in resuscitation measures and recommendations in postresuscitation interventions including induced hypothermia. Treatment with induced hypothermia after cardiac arrest for up to 24 hours has been shown to significantly improve the neurologic outcomes and mortality in patients with primary cardiac arrest who remain comatose after return of spontaneous circulation. St. Luke's Episcopal Hospital, a private, not-for-profit teaching hospital licensed for 949 beds located at the Texas Medical Center in Houston, Tex, has incorporated this research into practice. A multidisciplinary team led by a neurointensivist was formed to develop and implement a protocol to support induced hypothermia after cardiac arrest. Twenty-five patients have received induced hypothermia with a 74% survival rate. Of those who survived, 47% went home for a regular discharge, 29% transferred to acute rehabilitation, and 23% transferred to a long-term care facility.
尽管复苏实践取得了进展，但心脏骤停后的死亡率和神经功能障碍结局几乎没有改善。2005年发布了更新的复苏指南，其中包括复苏措施的变化以及复苏后干预措施（包括诱导低温）的建议。心脏骤停后进行长达24小时的诱导低温治疗已被证明可显著改善原发性心脏骤停患者在自主循环恢复后仍昏迷的神经功能结局和死亡率。圣卢克圣公会医院是一家位于德克萨斯州休斯顿市德克萨斯医疗中心的私立非营利性教学医院，拥有949张床位，已将这项研究应用于实践。一个由神经重症专家领导的多学科团队成立，以制定和实施一项支持心脏骤停后诱导低温的方案。25名患者接受了诱导低温治疗，存活率为74%。在存活的患者中，47%正常出院回家，29%转至急性康复机构，23%转至长期护理机构。
