Carwell Micaela
Penn Presbyterian Medical Center, University of Pennsylvania School of Nursing, University of Pennsylvania Health System, Philadelphia.
Crit Care Nurs Q. 2018 Apr/Jun;41(2):102-108. doi: 10.1097/CNQ.0000000000000199.
Therapeutic hypothermia, also referred to as targeted temperature management, has been a component of the postcardiac arrest treatment guidelines since 2010. Although almost a decade has passed since its inclusion in the postarrest guidelines, many unanswered questions remain regarding selection of the appropriate patient population, optimal target temperature, ideal window of time in which to initiate therapy after arrest, most efficient, safe, and accurate equipment choice for inducing and maintaining hypothermia, most effective duration of treatment, and rate of cooling or rewarming. On a national and international level, critical care nurses are in a unique position to participate in research that will define targeted temperature management protocols and practices. Nurses are also ideal for standardizing the targeted temperature management policy and protocol locally and nationally based on current available evidence. This review aims to serve 2 purposes: first, to provide a broad update on the current clarifications and limitations per research findings on target temperature management therapy; second, to explain how critical care nurses can use this updated information to improve outcomes for their patients with cardiac arrest.
治疗性低温，也称为目标温度管理，自2010年以来一直是心脏骤停后治疗指南的一部分。尽管自其被纳入骤停后指南以来已过去近十年，但关于合适患者群体的选择、最佳目标温度、骤停后开始治疗的理想时间窗、诱导和维持低温最有效、安全且准确的设备选择、最有效的治疗持续时间以及降温或复温速率等问题仍有许多未得到解答。在国家和国际层面，重症护理护士处于独特地位，能够参与确定目标温度管理方案和实践的研究。护士也是根据现有证据在本地和全国范围内规范目标温度管理政策和方案的理想人选。本综述旨在实现两个目的：第一，根据目标温度管理治疗的研究结果，对当前的澄清内容和局限性进行广泛更新；第二，解释重症护理护士如何利用这些更新信息改善心脏骤停患者的治疗效果。
