Department of Cardiovascular Medicine, Division of Cardiovascular Care Unit, National Cerebral and Cardiovascular Center, Suita, Japan.
Circ J. 2011;75(5):1063-70. doi: 10.1253/circj.cj-11-0137. Epub 2011 Apr 7.
Mild hypothermia is an effective therapy for patients with return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest. However, evidence of the effectiveness of therapeutic hypothermia (TH) remains unclear.
A multicenter registry in Japan (J-PULSE-HYPO study registry) was conducted to investigate the effectiveness of TH for post-resuscitation neurological dysfunction developing after out-of-hospital cardiac arrest from 14 institutions, between January 2005 and December 2009. The committee entrusted each hospital with the timing of cooling, cooling methods, target temperature, duration, and rewarming. There were 452 patients (375 men) enrolled into the registry. The mean age was 58.6 ± 13.5 years. Initial electrocardiogram rhythm at the time of occurrence of the cardiac arrest showed 68.9% had ventricular fibrillation or pulseless ventricular tachycardia, 13.7% had pulseless electrical activity, and 9.1% had asystole. The median interval from the occurrence of cardiac arrest to ROSC was 26 min. The target core temperature during TH was 33.9 ± 0.4°C and the mean duration of cooling was 31.5 ± 13.9 h. Intra-aortic balloon pumping was used in 40.1% and percutaneous cardiopulmonary support in 22.6% of patients. At 30 days after cardiac arrest, the proportion of survival was 80.1% and the proportion of patients with favorable neurological functions, with a cerebral performance category score of 1 or 2, was 55.3%.
The J-PULSE-HYPO study registry showed a clinical aspect of TH.
轻度低温是心肺复苏后自主循环恢复（ROSC）患者的有效治疗方法。然而，低温治疗（TH）的有效性证据仍不清楚。
日本（J-PULSE-HYPO 研究登记处）进行了一项多中心登记研究，以调查 14 家机构自 2005 年 1 月至 2009 年 12 月期间心肺复苏后发生的复苏后神经功能障碍的 TH 疗效。委员会委托每家医院决定冷却时机、冷却方法、目标温度、持续时间和复温。登记处纳入了 452 例患者（375 例男性）。平均年龄为 58.6±13.5 岁。心脏骤停时初始心电图节律显示 68.9%为心室颤动或无脉性室性心动过速，13.7%为无脉电活动，9.1%为心搏停止。从心脏骤停发生到 ROSC 的中位间隔为 26 分钟。TH 期间的目标核心温度为 33.9±0.4°C，平均冷却时间为 31.5±13.9 小时。40.1%的患者使用主动脉内球囊泵，22.6%的患者使用经皮心肺支持。心脏骤停后 30 天，存活率为 80.1%，神经功能良好的患者比例（Cerebral Performance Category 评分 1 或 2）为 55.3%。
J-PULSE-HYPO 研究登记处显示了 TH 的临床方面。
