The University of Texas Health Science Center at Houston, 2219 Dorrington St., Houston, TX 77030, USA.
Postgrad Med. 2010 Jan;122(1):19-27. doi: 10.3810/pgm.2010.01.2095.
The use of therapeutic hypothermia (TH) in acute care medicine has evolved over the past 2 centuries, and its use over the past decade has increased in emergency departments, intensive care units, and operating rooms. Therapeutic hypothermia has several potential clinical applications based on its putative mechanisms of action. It appears to improve oxygen supply to ischemic areas of the brain and decreases intracranial pressure. Mild-to-moderate TH (33 degrees C +/- 1 degrees C) after resuscitation from cardiac arrest is neuroprotective, and also acts on the cardiovascular system with evidence of a decrease in heart rate and increase in systemic vascular resistance. Therapeutic hypothermia decreases cardiac output by 7% for each 1 degrees C decrease in core body temperature, but maintains the stroke volume and the mean arterial pressure. Despite a growing amount of data, this life-saving technique is underutilized in hospitals worldwide. The purpose of this comprehensive review is to show the evolution and the clinical use of TH as it pertains to acute care practitioners.
在过去的两个世纪里，治疗性低温（therapeutic hypothermia，TH）在急症医学中的应用已经得到了发展，并且在过去十年中，在急诊科、重症监护病房和手术室中的应用有所增加。基于其推测的作用机制，治疗性低温有几种潜在的临床应用。它似乎可以改善大脑缺血区域的氧供应，并降低颅内压。心脏骤停复苏后进行轻度至中度 TH（33°C +/- 1°C）具有神经保护作用，并且对心血管系统也有作用，证据表明心率降低和全身血管阻力增加。治疗性低温使核心体温每降低 1°C，心输出量降低 7%，但维持每搏量和平均动脉压。尽管有越来越多的数据，但这种救生技术在全球医院的应用不足。本综述的目的是展示治疗性低温作为急性护理从业者的应用的发展和临床应用。
