Bjerregaard Jens, Kjærgaard Benedict
Anæstesiologisk Afdeling, Glostrup Hospital, Nordre Ringvej 57, 2600 Glostrup.
Ugeskr Laeger. 2014 Jan 6;176(1):64-7.
The treatment of accidental hypothermia is still controversial and is missing detailed evidence-based guidelines. Current knowledge suggests that advanced trauma life support principles must be prioritized ahead of rewarming. In case of cardiac arrest, initiation of extracorporeal circulation before rewarming and prolongation of hypothermia at 33 °C to reduce reperfusion injury and cerebral hyperthermia is recommended but is not as yet implemented as standard treatment. We propose a simplified clinical approach to on-site triage of hypothermia: 1. Awake below 35 °C (Glasgow Coma Scale > 8). 2. Unconscious below 32 °C. 3. Absent respiration and circulation below 32 °C.
意外低温的治疗仍存在争议，且缺乏详细的循证指南。目前的认知表明，在复温之前必须优先遵循高级创伤生命支持原则。对于心脏骤停的情况，建议在复温前启动体外循环，并将体温维持在33°C以延长低温时间，从而减少再灌注损伤和脑部过热，但这尚未作为标准治疗方法实施。我们提出一种用于现场低温分诊的简化临床方法：1. 体温低于35°C且清醒（格拉斯哥昏迷量表>8）。2. 体温低于32°C且无意识。3. 体温低于32°C且呼吸和循环停止。
