Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
Best Pract Res Clin Anaesthesiol. 2013 Sep;27(3):335-46. doi: 10.1016/j.bpa.2013.07.003.
More than 10 years ago, the randomised studies of therapeutic hypothermia after cardiac arrest showed significant improvement of neurological outcome and survival. Since then, it has become clear that most of the possible adverse events of therapeutic hypothermia are mild and can easily be controlled by proper administration of intensive care. Although implementation of this effective therapy is quite successful, many questions of the exact treatment protocol still remain unanswered. Therapeutic hypothermia treatment therefore must be tailored to the specific patient's needs. Hence, the exact level of target temperature, duration of cooling, rewarming, timing of the therapy and concomitant medication to facilitate therapeutic hypothermia will be important in the future. Additionally, the use of a post-resuscitation treatment bundle (specialised cardiac-arrest centres including intensive post-resuscitation care, appropriate haemodynamic and respiratory management, therapeutic hypothermia and percutaneous coronary intervention) could further improve treatment of cardiac arrest.
10 多年前，心脏骤停后治疗性低温的随机研究显示出神经功能预后和存活率的显著改善。从那时起，很明显，治疗性低温的大多数可能的不良事件都是轻微的，并且可以通过适当的重症监护管理来轻松控制。尽管这种有效的治疗方法的实施非常成功，但关于确切的治疗方案仍有许多问题尚未得到解答。因此，治疗性低温治疗必须根据特定患者的需求进行调整。因此，确切的目标温度水平、冷却持续时间、复温、治疗时机和促进治疗性低温的伴随药物在未来将很重要。此外，使用复苏后治疗包（包括专门的心脏骤停中心、强化复苏后护理、适当的血流动力学和呼吸管理、治疗性低温和经皮冠状动脉介入治疗）可进一步改善心脏骤停的治疗。
