Department of Oral and Maxillofacial Surgery, Medical School Hannover, Hannover, Germany.
Int J Cardiol. 2011 Nov 3;152(3):321-6. doi: 10.1016/j.ijcard.2010.07.026. Epub 2010 Aug 1.
Several studies have shown that mild hypothermia (32-34°C) markedly mitigates brain damage after cardiac arrest (CA). This study aimed to compare the efficacy of the non-invasive cooling device Hilotherm Clinic (Hilotherm GmbH, Germany) with conventional cooling to induce and maintain mild hypothermia in patients after out-of-hospital CA.
50 adult patients with an indication for controlled mild hypothermia were prospectively assigned to conventional cooling (n=20) or cooling with the Hilotherm system (n=30). Patients receiving a cooling therapy by Hilotherm were treated either with 0.35 m(2) (n=20) or with 0.7 m(2) (n=10) surface area of cooling sleeves.
The speed of cooling was significantly higher in both Hilotherm groups compared to conventional cooling (Hilotherm 0.7 m(2): 0.91 ± 0.08°C/h, Hilotherm 0.35 m(2): 0.47 ± 0.04°C/h, and conventional: 0.3 ± 0.04°C/h, p ≤ 0.003). Temperature deviation from the target temperature of 33°C was significantly higher in the conventional group compared to both Hilotherm groups. During induction of mild hypothermia a significant reduction of the mean arterial blood pressure and the heart rate was observed without significant differences between the groups. However, the speed of cooling (range 0.3-0.91°C/h) did not correlate to the decrease of blood pressure and heart rate. Norepinephrine dosing during induction of mild hypothermia and re-warming (1st-2nd day) was significantly increased compared to the 3rd day after admission in all groups. Dobutamine dosing and 30 days in-hospital mortality did not differ significantly between the groups.
Rapid and reliable mild hypothermia can be better achieved by the non-invasive cooling system Hilotherm compared to conventional cooling with ice packs and cold infusion.
多项研究表明，轻度低温（32-34°C）可显著减轻心脏骤停（CA）后的脑损伤。本研究旨在比较非侵入性冷却设备 Hilotherm Clinic（德国 Hilotherm GmbH）与常规冷却在诱导和维持院外 CA 后患者轻度低温方面的疗效。
50 名成人患者符合接受控制性轻度低温治疗的指征，前瞻性地分为常规冷却组（n=20）或 Hilotherm 系统冷却组（n=30）。接受 Hilotherm 冷却治疗的患者使用 0.35 m²（n=20）或 0.7 m²（n=10）的冷却套。
与常规冷却相比，两个 Hilotherm 组的冷却速度均显著提高（Hilotherm 0.7 m²：0.91±0.08°C/h，Hilotherm 0.35 m²：0.47±0.04°C/h，常规：0.3±0.04°C/h，p≤0.003）。与常规组相比，Hilotherm 组的目标温度 33°C 的温度偏差明显更高。在诱导轻度低温期间，两组的平均动脉血压和心率均显著降低，但组间无显著差异。然而，冷却速度（范围 0.3-0.91°C/h）与血压和心率的下降无关。与入院后第 3 天相比，所有组在诱导轻度低温和复温（第 1-2 天）期间的去甲肾上腺素剂量均显著增加。多巴酚丁胺剂量和 30 天院内死亡率在组间无显著差异。
与常规冰袋和冷输注相比，非侵入性冷却系统 Hilotherm 可更好地实现快速可靠的轻度低温。
