Department of Neurology, University of California, San Francisco, CA 94121, USA.
Ageing Res Rev. 2010 Jan;9(1):61-8. doi: 10.1016/j.arr.2009.10.002. Epub 2009 Oct 13.
Hypothermia is a well established cytoprotectant, with remarkable and consistent effects demonstrated across multiple laboratories. At the clinical level, it has recently been shown to improve neurological outcome following cardiac arrest and neonatal hypoxia-ischemia. It is increasingly being embraced by the medical community, and could be considered an effective neuroprotectant. Conditions such as brain injury, hepatic encephalopathy and cardiopulmonary bypass seem to benefit from this intervention. It's role in direct myocardial protection is also being explored. A review of the literature has demonstrated that in order to appreciate the maximum benefits of hypothermia, cooling needs to begin soon after the insult, and maintained for relatively long period periods of time. In the case of ischemic stroke, cooling should ideally be applied in conjunction with the re-establishment of cerebral perfusion. Translating this to the clinical arena can be challenging, given the technical challenges of rapidly and stably cooling patients. This review will discuss the application of hypothermia especially as it pertains to its effects neurological outcome, cooling methods, and important parameters in optimizing hypothermic protection.
低温是一种经过充分验证的细胞保护剂，在多个实验室中都表现出显著且一致的效果。在临床层面，低温治疗最近已被证明可以改善心脏骤停和新生儿缺氧缺血后的神经功能预后。它正逐渐被医学界所接受，并可能被视为一种有效的神经保护剂。脑损伤、肝性脑病和心肺旁路等疾病似乎都受益于这种干预措施。其在直接心肌保护中的作用也正在被探索。文献综述表明，为了最大限度地发挥低温的益处，冷却需要在损伤后尽快开始，并维持相对较长的时间。在缺血性中风的情况下，冷却应理想地与脑灌注的恢复同时进行。考虑到快速和稳定地冷却患者的技术挑战，将这一理论转化到临床领域可能具有挑战性。本文将讨论低温治疗的应用，特别是它对神经功能预后的影响、冷却方法以及优化低温保护的重要参数。
