Department of Clinical Sciences, Division of Neurology, Lund University, Lund, Sweden.
Resuscitation. 2013 Jul;84(7):867-72. doi: 10.1016/j.resuscitation.2013.01.019. Epub 2013 Jan 29.
Cardiopulmonary resuscitation is started in 5000 victims of out-of-hospital cardiac arrest in Sweden each year and the survival rate is approximately 10%. The subsequent development of a global ischaemic brain injury is the major determinant of the neurological prognosis for those patients who reach the hospital alive. Induced hypothermia is a recommended treatment after cardiac arrest and has been implemented in most Swedish hospitals. Recent studies indicate that induced hypothermia may affect neurological prognostication and previous international recommendations are therefore no longer valid when hypothermia is applied. An expert group from the Swedish Resuscitation Council has reviewed the literature and made recommendations taking into account the effects of induced hypothermia and concomitant sedation. A delayed neurological evaluation at 72 h after rewarming is recommended for hypothermia treated patients. This evaluation should be based on several independent methods and the possibility of lingering pharmacological effects should be considered.
在瑞典，每年有 5000 名院外心脏骤停的患者接受心肺复苏术，存活率约为 10%。随后发生的全脑缺血性损伤是那些存活到医院的患者神经预后的主要决定因素。心脏骤停后，诱导性低温是一种推荐的治疗方法，并且已经在大多数瑞典医院实施。最近的研究表明，诱导性低温可能会影响神经预后，因此，当应用低温时，以前的国际建议不再有效。瑞典复苏委员会的一个专家组审查了文献，并考虑了诱导性低温和伴随镇静的影响提出了建议。建议对接受低温治疗的患者在复温后 72 小时进行延迟神经评估。该评估应基于几种独立的方法，并应考虑持续存在的药物作用的可能性。
