Sugerman Noah T, Abella Benjamin S
Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
J Neurotrauma. 2009 Mar;26(3):371-6. doi: 10.1089/neu.2008.0588.
Improving survival and brain function after initial resuscitation from cardiac arrest remains a critical challenge with few therapeutic options. The publication of several randomized controlled trials supporting the use of therapeutic hypothermia in cardiac arrest survivors has provided a remarkable opportunity to reduce mortality and neurologic disability from this leading cause of death. On the strength of these trials, therapeutic hypothermia has now been incorporated in the American Heart Association guidelines for post-resuscitation care. This review will focus on the hospital-based application of therapeutic hypothermia in adult cardiac arrest survivors, with special attention to practical aspects of cooling, protocol development, and evaluation of recent data from "real world" experiences using hypothermia as a treatment option. Finally, remaining research questions and directions for future improvements in therapy will be discussed.
在心脏骤停初始复苏后提高生存率和脑功能仍然是一项严峻挑战，治疗选择寥寥无几。几项支持对心脏骤停幸存者使用治疗性低温的随机对照试验的发表，为降低这一致死主因导致的死亡率和神经功能残疾提供了显著契机。基于这些试验的结果，治疗性低温现已被纳入美国心脏协会的复苏后护理指南。本综述将聚焦于治疗性低温在成年心脏骤停幸存者中的院内应用，特别关注降温的实际操作、方案制定以及对将低温作为治疗选择的“真实世界”经验的近期数据评估。最后，将讨论剩余的研究问题以及未来治疗改进的方向。
