Kochanek Patrick M, Fink Ericka L, Bell Michael J, Bayir Hülya, Clark Robert S B
Department of Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15260, USA.
J Neurotrauma. 2009 Mar;26(3):421-7. doi: 10.1089/neu.2008.0587.
There is a rich history for the use of therapeutic hypothermia after cardiac arrest in neonatology and pediatrics. Laboratory reports date back to 1824 in experimental perinatal asphyxia. Similarly, clinical reports in pediatric cold water drowning victims represented key initiating work in the field. The application of therapeutic hypothermia in pediatric drowning victims represented some of the seminal clinical use of this modality in modern neurointensive care. Uncontrolled application (too deep and too long) and unique facets of asphyxial cardiac arrest in children (a very difficult insult to affect any benefit) likely combined to result in abandonment of therapeutic hypothermia in the mid to late 1980s. Important studies in perinatal medicine have built upon the landmark clinical trials in adults, and are once again bringing therapeutic hypothermia into standard care for pediatrics. Although more work is needed, particularly in the use of mild therapeutic hypothermia in children, there is a strong possibility that this important therapy will ultimately have broad applications after cardiac arrest and central nervous system (CNS) insults in the pediatric arena.
在新生儿学和儿科学领域，心脏骤停后使用治疗性低温有着丰富的历史。实验室报告可追溯到1824年的围产期窒息实验。同样，儿科冷水溺水受害者的临床报告是该领域的关键开创性工作。治疗性低温在儿科溺水受害者中的应用代表了这种治疗方式在现代神经重症监护中的一些开创性临床应用。不受控制的应用（温度过低、时间过长）以及儿童窒息性心脏骤停的独特方面（很难产生任何益处的严重损伤）可能共同导致在20世纪80年代中后期放弃治疗性低温。围产期医学的重要研究建立在成人的里程碑式临床试验基础上，并且再次将治疗性低温带入儿科的标准治疗中。尽管还需要做更多工作，特别是在儿童中使用轻度治疗性低温方面，但这种重要疗法极有可能最终在儿科领域心脏骤停和中枢神经系统（CNS）损伤后得到广泛应用。
