British Antarctic Survey Medical Unit, Emergency Department, Derriford Hospital, Plymouth, UK.
Int J Circumpolar Health. 2023 Dec;82(1):2210340. doi: 10.1080/22423982.2023.2210340.
Cold Weather Injury (CWI) represents a spectrum of pathology, the two main divisions being Freezing Cold Injury (FCI) and Non-Freezing Cold Injury (NFCI). Both are disabling conditions associated with microvascular and nerve injury often treated hours after initial insult when presenting to a healthcarestablishment. Given that iloprost is used for the treatment of FCI, could it be used in a forward operating environment to mitigate treatment delay? Is there a role for its use in the forward treatment of NFCI? This review sought to evaluate the strength of evidence for the potential use of iloprost in a forward operating environment.
Literature searches were undertaken using the following question for both FCI and NFCI: in [patients with FCI/NFCI] does [the use of iloprost] compared to [standard care] reduce the incidence of [long-term complications]. Medline, CINAHL and EMBASE databases were searched using the above question and relevant alternative terminology. Abstracts were reviewed before full articles were requested.
The FCI search yielded 17 articles that were found to refer to the use of iloprost and FCI. Of the 17, one referred to pre-hospital treatment of frostbite at K2 base camp; however, this was utilising tPA. No articles referred to pre-hospital use in either FCI or NFCI.
Although evidence exists to support the use of iloprost in the treatment of FCI, its use to date has been in hospital. A common theme is delayed treatment due to the challenges of evacuating casualties from a remote location. There may be a role for iloprost in the treatment of FCI; however, further study is required to better understand the risk of its use.
寒冷天气损伤（CWI）代表了一系列病理学，主要分为冻结性冷损伤（FCI）和非冻结性冷损伤（NFCI）。两者都是与微血管和神经损伤相关的致残疾病，通常在最初损伤后数小时，在医疗机构就诊时才得到治疗。鉴于伊洛前列素用于治疗 FCI，是否可以在前沿作战环境中使用它来减少治疗延迟？它在 NFCI 的前沿治疗中是否有作用？本综述旨在评估伊洛前列素在前沿作战环境中潜在使用的证据强度。
使用以下问题对 FCI 和 NFCI 进行文献检索：在 [患有 FCI/NFCI 的患者] 中，[使用伊洛前列素]与 [标准护理] 相比，是否能减少 [长期并发症] 的发生率。使用上述问题和相关替代术语在 Medline、CINAHL 和 EMBASE 数据库中进行了检索，并对摘要进行了审查，然后请求了全文。
FCI 搜索结果产生了 17 篇文章，这些文章都提到了伊洛前列素和 FCI 的使用。在这 17 篇文章中，有一篇提到了在 K2 大本营对冻伤的院前治疗；然而，这是利用 tPA 进行的。没有文章提到 FCI 或 NFCI 的院前使用。
尽管有证据支持伊洛前列素在 FCI 治疗中的应用，但迄今为止，它仅在医院使用。一个常见的主题是由于从偏远地区疏散伤员的挑战而导致治疗延迟。伊洛前列素在 FCI 的治疗中可能有一定作用；然而，需要进一步的研究来更好地了解其使用的风险。
