Schlunt Michelle L, Wang Lynn
Department of Anesthesiology, Loma Linda University School of Medicine, California, USA.
J Emerg Trauma Shock. 2010 Jul;3(3):277-81. doi: 10.4103/0974-2700.66533.
The survival outcome following pediatric cardiac arrest still remains poor. Survival to hospital discharge ranges anywhere from 0 to 38% when considering both out-of-hospital and in-hospital arrests, with up to 50% of the survivors having neurologic injury. The use of mild induced hypothermia has not been definitively proven to improve outcomes following pediatric cardiac arrest. This may be due to the lack of consensus regarding target temperature, best method of cooling, optimal duration of cooling and identifying the patient population who will receive the greatest benefit. We review the current applications of induced hypothermia in pediatric patients following cardiac arrest after searching the current literature through Pubmed and Ovid journal databases. We put forth compiled recommendations/guidelines for initiating hypothermia therapy, its maintenance, associated monitoring and suggested adjunctive therapies to produce favorable neurologic and survival outcomes.
小儿心脏骤停后的生存结局仍然很差。考虑到院外和院内心脏骤停,出院生存率在0%至38%之间,高达50%的幸存者有神经损伤。轻度低温诱导疗法尚未被明确证明能改善小儿心脏骤停后的结局。这可能是由于在目标温度、最佳降温方法、最佳降温持续时间以及确定能从治疗中获得最大益处的患者群体等方面缺乏共识。我们通过PubMed和Ovid期刊数据库检索当前文献,回顾了低温诱导疗法在小儿心脏骤停患者中的当前应用情况。我们提出了关于启动低温治疗、维持治疗、相关监测以及建议的辅助治疗的综合建议/指南,以产生良好的神经和生存结局。