Kämäräinen Antti, Virkkunen Ilkka, Tenhunen Jyrki, Yli-Hankala Arvi, Silfvast Tom
Medical School, University of Tampere, Tampere, Finland.
Resuscitation. 2008 Nov;79(2):205-11. doi: 10.1016/j.resuscitation.2008.07.003. Epub 2008 Sep 21.
Primarily, to investigate induction of therapeutic hypothermia during prehospital cardiopulmonary resuscitation (CPR) using ice-cold intravenous fluids. Effects on return of spontaneous circulation (ROSC), rate of rearrest, temperature and haemodynamics were assessed. Additionally, the outcome was followed until discharge from hospital.
Seventeen adult prehospital patients without obvious external causes for cardiac arrest were included. During CPR and after ROSC, paramedics infused +4 degrees C Ringer's acetate aiming at a target temperature of 33 degrees C.
ROSC was achieved in 13 patients, 11 of whom were admitted to hospital. Their mean initial nasopharyngeal temperature was 35.17+/-0.57 degrees C (95% CI), and their temperature on hospital admission was 33.83+/-0.77 degrees C (-1.34 degrees C, p<0.001). The mean infused volume of cold fluid was 1571+/-517 ml. The rate of rearrest after ROSC was not increased compared to previous reports. Hypotension was observed in five patients. Of the 17 patients, 1 survived to hospital discharge.
Induction of therapeutic hypothermia during prehospital CPR and after ROSC using ice-cold Ringer's solution effectively decreased nasopharyngeal temperature. The treatment was easily carried out and well tolerated.
主要是调查在院前心肺复苏（CPR）期间使用冰冷静脉输液诱导治疗性低温的情况。评估其对自主循环恢复（ROSC）、再次骤停率、体温和血流动力学的影响。此外，随访结果直至出院。
纳入17例无明显心脏骤停外部原因的成年院前患者。在心肺复苏期间及自主循环恢复后，护理人员输注4℃的醋酸林格液，目标体温为33℃。
13例患者实现了自主循环恢复，其中11例入院。他们的平均初始鼻咽温度为35.17±0.57℃（95%置信区间），入院时体温为33.83±0.77℃（下降1.34℃，p<0.001）。冷液体的平均输注量为1571±517ml。自主循环恢复后的再次骤停率与先前报道相比没有增加。5例患者出现低血压。17例患者中，1例存活至出院。
在院前心肺复苏期间及自主循环恢复后使用冰冷林格液诱导治疗性低温可有效降低鼻咽温度。该治疗操作简便且耐受性良好。
