Bernard S
Intensive Care Unit, Dandenong Hospital, Victoria.
Anaesth Intensive Care. 1996 Jun;24(3):382-8. doi: 10.1177/0310057X9602400315.
Induced hypothermia as adjunctive therapy has been the subject of considerable research interest and debate for over fifty years. Recently the first prospective randomized controlled trials were undertaken in humans with severe traumatic brain injury, with supportive results. Another prospective controlled study of induced hypothermia in severe septic adult respiratory distress syndrome also suggested improved outcome. Other studies in patients with anoxic brain injury have been suggested following promising findings in animal models. There have been anecdotal reports of the use of induced hypothermia in a wide range of other neurological injuries. There are significant physiological changes during induced hypothermia, particularly affecting the cardiovascular system. In addition, hypokalaemia, prolonged clotting times and neutropenia may occur. The evidence that induced hypothermia may be hazardous is mostly drawn from the literature on accidental hypothermia occurring in trauma, or patients with sepsis. It is likely that further trials will be conducted and if benefit is confirmed, induced hypothermia may become more widely used in selected patients in the intensive care unit.
五十多年来，诱导性低温作为辅助治疗一直是大量研究关注和争论的主题。最近，针对重度创伤性脑损伤患者开展了首批前瞻性随机对照试验，结果支持这一疗法。另一项针对重度脓毒症成人呼吸窘迫综合征患者的诱导性低温前瞻性对照研究也表明预后有所改善。鉴于在动物模型中取得了有前景的发现，也有人提议对缺氧性脑损伤患者开展其他研究。还有一些轶事报道称，诱导性低温被用于多种其他神经损伤。诱导性低温期间会发生显著的生理变化，尤其会影响心血管系统。此外，还可能出现低钾血症、凝血时间延长和中性粒细胞减少。诱导性低温可能有害的证据大多来自有关创伤或脓毒症患者意外低温的文献。很可能会开展进一步试验，如果其益处得到证实，诱导性低温可能会在重症监护病房的特定患者中得到更广泛应用。
