Rincon Fred
Division of Critical Care and Neurotrauma, Department of Neurology, Sidney-Kimmel College of Medicine, Thomas Jefferson University, 909 Walnut Street, 3rd Floor, Philadelphia, PA 19107, USA; Division of Critical Care and Neurotrauma, Department of Neurological Surgery, Sidney-Kimmel College of Medicine, Thomas Jefferson University, 909 Walnut Street, 3rd Floor, Philadelphia, PA 19107, USA.
Neurol Clin. 2017 Nov;35(4):665-694. doi: 10.1016/j.ncl.2017.06.005.
Evidence from animal models indicates that lowering temperature by a few degrees can produce substantial neuroprotection. In humans, hypothermia has been found to be neuroprotective with a significant impact on mortality and long-term functional outcome only in cardiac arrest and neonatal hypoxic-ischemic encephalopathy. Clinical trials have explored the potential role of maintaining normothermia and treating fever in critically ill brain injured patients. This review concentrates on basic concepts to understand the physiologic interactions of thermoregulation, effects of thermal modulation in critically ill patients, proposed mechanisms of action of temperature modulation, and practical aspects of targeted temperature management.
动物模型的证据表明，体温降低几度可产生显著的神经保护作用。在人类中，仅在心脏骤停和新生儿缺氧缺血性脑病中，低温被发现具有神经保护作用，对死亡率和长期功能结局有显著影响。临床试验探讨了在重症脑损伤患者中维持正常体温和治疗发热的潜在作用。本综述集中于基本概念，以理解体温调节的生理相互作用、热调节对重症患者的影响、温度调节的作用机制以及目标温度管理的实际方面。
