Fischer Doris, Allendorf Antje, Buxmann Horst, Weiss Katja, Schloesser Rolf L
Division of Neonatology, Department of Pediatrics, JW Goethe-University Hospital, Frankfurt, Germany.
Am J Perinatol. 2014 Apr;31(4):257-60. doi: 10.1055/s-0033-1349343. Epub 2013 Jul 9.
Therapeutic hypothermia is an established therapeutic regimen in severely asphyxiated term neonates. The amount of cerebral injury is reduced resulting in an improved neurologic outcome. Therapeutic hypothermia-induced side effects mostly affect the circulatory system, kidney, and liver. However, asphyxia and hypothermia in itself reduce the hemostatic capacity of each individual organism.
A case of a neonate with severe asphyxia and purpura fulminans after hypothermia is described.
Although purpura fulminans cannot be attributed to hypothermia solely, the influence of hypothermia on hemostasis may have promoted severe coagulopathy with a fatal outcome. Further studies are necessary to reveal therapeutic hypothermia as a trigger for severe coagulopathies in asphyxiated neonates, especially in those with sepsis and overt coagulopathy prior to therapeutic hypothermia.
治疗性低温是足月重度窒息新生儿既定的治疗方案。可减少脑损伤量，从而改善神经学预后。治疗性低温引起的副作用主要影响循环系统、肾脏和肝脏。然而，窒息和低温本身会降低每个个体的止血能力。
描述了1例新生儿重度窒息并在低温治疗后发生暴发性紫癜的病例。
虽然暴发性紫癜不能仅归因于低温，但低温对止血的影响可能促进了严重凝血病并导致致命后果。有必要开展进一步研究，以揭示治疗性低温是窒息新生儿尤其是那些在治疗性低温前患有败血症和明显凝血病的新生儿发生严重凝血病的触发因素。
