EVMS Internal Medicine, Norfolk, VA 2350, USA.
Am J Emerg Med. 2010 Feb;28(2):258.e1-4. doi: 10.1016/j.ajem.2009.05.023.
Therapeutic hypothermia has been reported to improve the neurologic outcome of comatose survivors of out-of-hospital cardiac arrest. The use of therapeutic hypothermia in patients who have had an acute ischemic-hypoxic brain injury after a suicidal intoxication has not been previously reported. We present the case of a young woman who presented comatose to our emergency department after attempting suicide by ingesting diazepam and a bottle of antifreeze (ethylene-glycol). Despite aggressive supportive care, the patient progressed to what appeared to be clinical brain death. At this point, the patient was managed with therapeutic hypothermia for 36 hours. The patient awoke within 48 hours of rewarming and made a complete and full neurologic recovery. In conclusion, this case has important implications in the management of patients who have had an acute ischemichypoxic brain injury. Inappropriately labeling such patients as "brain dead" will result in the failure to institute therapeutic hypothermia and other advanced neuroprotective interventions in patients who could be salvaged with a good neurologic outcome.
治疗性低温已被报道可改善院外心脏骤停后昏迷幸存者的神经预后。在因自杀性中毒导致急性缺血缺氧性脑损伤的患者中使用治疗性低温尚未有报道。我们报告了一例年轻女性的病例，她因服用安定和一瓶防冻液（乙二醇）自杀后昏迷被送入我们的急诊室。尽管进行了积极的支持性治疗，患者还是进展到了临床脑死亡。在这一点上，对患者进行了 36 小时的治疗性低温治疗。患者在复温后 48 小时内醒来，并完全恢复了神经功能。总之，这个病例在管理急性缺血缺氧性脑损伤患者方面具有重要意义。如果不恰当地将此类患者标记为“脑死亡”，将会导致未能对可能通过良好神经预后挽救的患者进行治疗性低温和其他高级神经保护干预。
