Department of Emergency Medicine, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
Scand J Trauma Resusc Emerg Med. 2009 Oct 12;17:52. doi: 10.1186/1757-7241-17-52.
Despite many years of research, outcome after cardiac arrest is dismal. Since 2005, the European Resuscitation Council recommends in its guidelines the use of mild therapeutic hypothermia (32-34 degrees) for 12 to 24 hours in patients successfully resuscitated from cardiac arrest. The benefit of resuscitative mild hypothermia (induced after resuscitation) is well established, while the benefit of preservative mild to moderate hypothermia (induced during cardiac arrest) needs further investigation before recommending it for clinical routine. Animal data and limited human data suggest that early and fast cooling might be essential for the beneficial effect of resuscitative mild hypothermia. Out-of-hospital cooling has been shown to be feasible and safe by means of intravenous infusion with cold fluids or non-invasively with cooling pads. A combination of these cooling methods might further improve cooling efficacy. If out-of-hospital cooling will further improve functional outcome as compared with in-hospital cooling needs to be determined in a prospective, randomised, sufficiently powered clinical trial.
尽管经过多年研究，心脏骤停后的结果仍然不容乐观。自 2005 年以来，欧洲复苏委员会在其指南中建议对成功复苏的心脏骤停患者使用 12 至 24 小时的温和治疗性低体温（32-34 度）。复苏性轻度低温（在复苏后诱导）的益处已得到充分证实，而预防性轻度至中度低温（在心脏骤停期间诱导）的益处需要进一步研究，然后才能推荐用于临床常规。动物数据和有限的人类数据表明，早期和快速降温对于复苏性轻度低温的有益作用可能至关重要。通过静脉输注冷液或非侵入性使用冷却垫已经证明院外降温是可行和安全的。这些冷却方法的组合可能会进一步提高冷却效果。如果院外降温与院内降温相比能进一步改善功能预后，则需要在一项前瞻性、随机、充分有力的临床试验中确定。
