Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Injury. 2011 Sep;42(9):843-54. doi: 10.1016/j.injury.2011.03.027. Epub 2011 Apr 9.
Therapeutic hypothermia involves the controlled reduction of core temperature to attenuate the secondary organ damage which occurs following a primary injury. Clinicians have been increasingly using therapeutic hypothermia to prevent or ameliorate various types of neurological injury and more recently for some forms of cardiac injury. In addition, some recent evidence suggests that therapeutic hypothermia may also provide benefit following acute kidney injury. In this review we will examine the potential mechanisms of action and current clinical evidence surrounding the use of therapeutic hypothermia. We will discuss the ideal methodological attributes of future studies using hypothermia to optimise outcomes following organ injury, in particular neurological injury. We will assess the importance of target hypothermic temperature, time to achieve target temperature, duration of cooling, and re-warming rate on outcomes following neurological injury to gain insights into important factors which may also influence the success of hypothermia in other organ injuries, such as the heart and the kidney. Finally, we will examine the potential of therapeutic hypothermia as a future kidney protective therapy.
治疗性低温涉及核心体温的受控降低，以减轻原发性损伤后发生的继发性器官损伤。临床医生越来越多地使用治疗性低温来预防或改善各种类型的神经损伤，最近也用于某些类型的心脏损伤。此外，一些最近的证据表明，治疗性低温在急性肾损伤后也可能有益。在这篇综述中，我们将检查围绕治疗性低温使用的潜在作用机制和当前临床证据。我们将讨论使用低温来优化器官损伤（特别是神经损伤）后结果的未来研究的理想方法学属性。我们将评估目标低温温度、达到目标温度的时间、冷却持续时间和复温速度对神经损伤后结果的重要性，以深入了解可能也会影响低温在其他器官损伤（如心脏和肾脏）中的成功的重要因素。最后，我们将研究治疗性低温作为未来肾脏保护治疗的潜力。
