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一项比较中度全身低温与常温治疗急性颈脊髓损伤的并发症谱的前瞻性多中心研究。

A prospective multi-center study comparing the complication profile of modest systemic hypothermia versus normothermia for acute cervical spinal cord injury.

机构信息

Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.

The Miami Project to Cure Paralysis, Miami, FL, USA.

出版信息

Spinal Cord. 2022 Jun;60(6):510-515. doi: 10.1038/s41393-021-00747-w. Epub 2022 Jan 10.

Abstract

STUDY DESIGN

Prospective multi-center trial.

OBJECTIVES

To characterize the complication profile associated with modest systemic hypothermia after acute cervical SCI in a prospective multi-center study.

SETTING

Five trauma centers in the United States.

METHODS

We analyzed data from a prospective, multi-center trial on the use of modest systemic hypothermia for acute cervical SCI. Patients with acute cervical SCI were assigned to receive modest systemic hypothermia (33 C) or standard of care medical treatment. Patients in the hypothermia group were cooled to 33 C and maintained at the target temperature for 48 h. Complication profile and the rate of complications within the first 6 weeks after injury were compared between the two groups. Multiple regression analysis was performed to determine risk factors for complications after injury.

RESULTS

Fifty patients (hypothermia: 27, control: 23) were analyzed for this study. Median age was significantly lower in the hypothermia arm (39 vs 59 years, p = 0.02). Respiratory complications were the most common (hypothermia: 55.6% vs control: 52.2%, p = 0.81). The rate of deep vein thrombosis was not significantly different between the two groups (hypothermia: 14.8% vs control 17.4%, p = 0.71). The rate of complications was not statistically different between the two groups.

CONCLUSION

In this prospective multi-center controlled trial, preliminary data show that modest systemic hypothermia was not associated with increased risk of complications within the first 6 weeks after acute cervical SCI.

TRIAL INFORMATION

The study is registered on clinicaltrials.gov NCT02991690. University of Miami IRB (Central IRB) approval No.: 20160758. Emory University IRB #IRB00093786.

摘要

研究设计

前瞻性多中心试验。

目的

在一项前瞻性多中心研究中,描述中度全身低温治疗急性颈脊髓损伤后相关并发症。

地点

美国五个创伤中心。

方法

我们分析了一项关于中度全身低温治疗急性颈脊髓损伤的前瞻性、多中心试验的数据。急性颈脊髓损伤患者被分为接受中度全身低温(33°C)或标准医疗治疗。低温组患者被冷却至 33°C 并保持目标温度 48 小时。比较两组患者伤后 6 周内的并发症情况和并发症发生率。采用多因素回归分析确定伤后并发症的危险因素。

结果

本研究共分析了 50 例患者(低温组 27 例,对照组 23 例)。低温组患者的中位年龄明显低于对照组(39 岁 vs 59 岁,p=0.02)。呼吸系统并发症是最常见的(低温组 55.6%,对照组 52.2%,p=0.81)。两组深静脉血栓形成的发生率无显著差异(低温组 14.8%,对照组 17.4%,p=0.71)。两组并发症发生率无统计学差异。

结论

在这项前瞻性多中心对照试验中,初步数据表明中度全身低温治疗急性颈脊髓损伤后 6 周内并发症风险无增加。

试验信息

该研究在 clinicaltrials.gov 注册,编号为 NCT02991690。迈阿密大学 IRB(中央 IRB)批准号:20160758。埃默里大学 IRB #IRB00093786。

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