Alfonzo Annette, Lomas Annie, Drummond Iain, McGugan Elizabeth
Renal Unit, Queen Margaret Hospital, Dunfermline, Fife, UK.
Nephrol Dial Transplant. 2009 Mar;24(3):1054-6. doi: 10.1093/ndt/gfn674. Epub 2008 Dec 4.
Hypothermic cardiac arrest is associated with a high mortality despite advances in pre-hospital rescue, rewarming techniques and intensive care management. Prolonged resuscitation is justified and full neurological recovery has been described using various methods of extracorporeal rewarming (Vretenar DF, Urschel JD, Parrott JCW et al. Ann Thorac Surg 1994; 58: 895-898; Hughes A, Riou P, Day C. Emerg Med J 2007; 24: 511-512). Extracorporeal rewarming is usually required at temperatures below 32 degrees C or in the presence of cardiovascular instability or neurological dysfunction (Wilkey SA. Am J Clin Med 2004; 1: 4-11). Resuscitation guidelines suggest cardiopulmonary bypass (CPB) as the method of choice in cardiac arrest, but in practice availability is restricted (Soar J, Deakin CD, Nolan JP et al. Resuscitation 2005; 67: S135-S170). Continuous veno-venous haemofiltration (CVVH) is an alternative, but underutilized approach which warrants further consideration given its ease and wider availability.
尽管在院前急救、复温技术和重症监护管理方面取得了进展，但低温性心脏骤停的死亡率仍然很高。延长复苏是合理的，并且已经描述了使用各种体外复温方法实现完全神经功能恢复的情况（Vretenar DF、Urschel JD、Parrott JCW等人。《胸外科年鉴》1994年；58：895 - 898；Hughes A、Riou P、Day C。《急诊医学杂志》2007年；24：511 - 512）。通常在体温低于32摄氏度或存在心血管不稳定或神经功能障碍时需要进行体外复温（Wilkey SA。《美国临床医学杂志》2004年；1：4 - 11）。复苏指南建议将体外循环（CPB）作为心脏骤停的首选方法，但在实际应用中其可用性受到限制（Soar J、Deakin CD、Nolan JP等人。《复苏》2005年；67：S135 - S170）。持续静脉 - 静脉血液滤过（CVVH）是一种替代方法，但未得到充分利用，鉴于其简便性和更广泛的可用性，值得进一步考虑。
