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治疗性低温启动期间全身血液循环紊乱的研究:低温的陷阱

The study of systemic general circulation disturbance during the initiation of therapeutic hypothermia: Pit fall of hypothermia.

作者信息

Honda Mitsuru, Yokota Kyosuke, Ichibayashi Ryo, Yoshihara Katsunori, Masuda Hiroyuki, Uekusa Hiroyuki, Seiki Yoshikatsu, Nomoto Jun, Nagao Takeki, Kishi Taichi, Sase Shigeru

机构信息

Department of Critical Care Center, Toho University Medical Center, Omori Hospital, Ota-ku, Tokyo, Japan.

出版信息

Asian J Neurosurg. 2012 Apr;7(2):61-5. doi: 10.4103/1793-5482.98645.

Abstract

AIMS

Neurointensive care has reduced the mortality and improved the outcome of patients for severe brain damage, over recent decades, and made it possible to perform this therapy in safety. However, we have to understand the complications of this therapy well. The purpose of our study was to determine the systemic circulation disturbance during the initiation of therapeutic hypothermia by using this continuous neurointensive monitoring system.

MATERIALS AND METHODS

Ten severe brain damage patients treated with hypothermia were enrolled. All patients had Glasgow Coma Scale (GCS) less than or equal to 8, on admission.

RESULTS

We verified that heart rate, cardiac output, and oxygen delivery index (DO2I) decreased with decreasing core temperature. We recognized that depressed cardiac index (CI) was attributed to bradycardia, dehydration, and increased systemic vascular resistance index (SVRI) upon initiation of hypothermia.

CONCLUSION

Although the hypothermia has a therapeutic role in severe brain damage patients, we have to carry out this therapy while maintaining their cardiac output using multimodality monitoring devices during hypothermia period.

摘要

目的

近几十年来,神经重症监护降低了严重脑损伤患者的死亡率,改善了其预后,并使安全实施这种治疗成为可能。然而,我们必须充分了解这种治疗的并发症。我们研究的目的是使用这种连续神经重症监测系统来确定治疗性低温启动期间的体循环紊乱。

材料与方法

招募了10名接受低温治疗的严重脑损伤患者。所有患者入院时格拉斯哥昏迷量表(GCS)均小于或等于8分。

结果

我们证实心率、心输出量和氧输送指数(DO2I)随核心温度降低而下降。我们认识到,低温启动时心脏指数(CI)降低归因于心动过缓、脱水和全身血管阻力指数(SVRI)升高。

结论

尽管低温对严重脑损伤患者具有治疗作用,但在低温治疗期间,我们必须使用多模态监测设备维持其心输出量的同时进行这种治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a096/3410162/28f89db95dbb/AJNS-7-61-g005.jpg

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