心脏停搏后亚低温治疗改善多器官功能障碍。
Mild hypothermia in improving multiple organ dysfunction after cardiac arrest.
机构信息
Department of Emergency and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
出版信息
World J Emerg Med. 2010;1(3):196-200.
BACKGROUND
Resuscitation after cardiac arrest (CA) with a whole-body ischemia-reperfusion injury causes brain injury and multiple organ dysfunction (MODS). This study aimed to determine whether mild systemic hypothermia could decrease multiple organ dysfunctions after resuscitation from cardiac arrest.
METHODS
The patients who had been resuscitated after cardiac arrest were reviewed. During the resuscitation they had been assigned to undergo therapeutic hypothermia (target temperature, 32°C to 34°C, measured in the rectum) over a period of 24 to 36 hours or to receive standard treatment with normothermia. Markers of different organ injury were evaluated for the first 72 hours after recovery of spontaneous circulation (ROSC).
RESULTS
At 72 hours after ROSC, 23 patients in the hypothermia group for whom data were available had favorable neurologic, myocardial, hepatic and pulmonic outcomes as compared with 26 patients in the normothermia group. The values of renal function were not significantly different between the two groups. However, blood coagulation function was badly injured in the hypothermia group.
CONCLUSION
In the patients who have been successfully resuscitated after cardiac arrest, therapeutic mild hypothermia can alleviate dysfunction after resuscitation from cardiac arrest.
背景
心脏骤停（CA）后全身缺血再灌注损伤引起脑损伤和多器官功能障碍（MODS）。本研究旨在确定轻度全身低温是否可以减少心脏骤停复苏后的多器官功能障碍。
方法
回顾了心脏骤停后接受复苏的患者。在复苏过程中，他们被分配接受 24 至 36 小时的治疗性低温（直肠内目标温度为 32°C 至 34°C）或接受常规的常温治疗。在自主循环恢复（ROSC）后 72 小时评估了不同器官损伤的标志物。
结果
在 ROSC 后 72 小时，可获得数据的低温组 23 例患者的神经、心肌、肝和肺功能预后良好，而常温组 26 例患者的神经、心肌、肝和肺功能预后良好。两组肾功能值无显著差异。然而，低温组的凝血功能严重受损。
结论
在成功复苏后的心脏骤停患者中，治疗性轻度低温可减轻心脏骤停复苏后的功能障碍。
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