Clinical application of mild therapeutic hypothermia after cardiac arrest
Clinical application of mild therapeutic hypothermia after cardiac arrest
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DOI：
10.1097/01.ccm.0000259383.48324.35
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发表时间：
2007-04-01
影响因子：
8.8
通讯作者：
Arrich, Jasmin
中科院分区：
文献类型：
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作者：
Arrich, Jasmin
Objective.复苏后轻度低温可降低死亡率，减少心脏骤停后的神经功能损害，是国际复苏联络委员会推荐的方法。欧洲复苏理事会心脏骤停后低温登记处的成立是为了监测治疗性低温的实施，观察遵守指南的可行性，并记录低温治疗在并发症和结局方面的影响。设计：心脏骤停协议，根据Utstein风格，记录冷却和复温程序和可能的不良事件的附加协议。设置：在2003年3月和2005年6月之间，来自欧洲19个地点的650例患者的数据被输入。患者：患者心脏骤停与自主循环的成功恢复进行了研究。测量和主要结果。在所有患者中，462例（79%）接受了低温治疗，347例（59%）使用血管内器械冷却，114例（19%）接受了其他冷却方法，如冰袋、冷却毯和冷液。平均降温速率为每小时1.1摄氏度。在所有低体温患者中，15例（3%）在冷却后7天内发生出血，28例（6%）至少发生一次心律失常。没有死亡的结果cooling.Conclusions：治疗性低温是可行的，可以安全有效地使用随机临床试验之外。不良事件发生率较低，冷却速度比已发表的临床试验快。
Objective. Postresuscitative mild hypothermia lowers mortality, reduces neurologic impairment after cardiac arrest, and is recommended by the International Liaison Committee on Resuscitation. The European Resuscitation Council Hypothermia After Cardiac Arrest Registry was founded to monitor implementation of therapeutic hypothermia, to observe feasibility of adherence to the guidelines, and to document the effects of hypothermic treatment in terms of complications and outcome.Design: Cardiac arrest protocols, according to Utstein style, with additional protocols on cooling and rewarming procedures and possible adverse events are documented.Setting: Between March 2003 and June 2005, data on 650 patients from 19 sites within Europe were entered.Patients: Patients who had cardiac arrest with successful restoration of spontaneous circulation were studied.Measurements and Main Results. Of all patients, 462 (79%) received therapeutic hypothermia, 347 (59%) were cooled with an endovascular device, and 114 (19%) received other cooling methods such as ice packs, cooling blankets, and cold fluids. The median cooling rate was 1.1 degrees C per hour. Of all hypothermia patients, 15 (3%) had an episode of hemorrhage and 28 patients (6%) had at least one episode of arrhythmia within 7 days after cooling. There were no fatalities as a result of cooling.Conclusions: Therapeutic hypothermia is feasible and can be used safely and effectively outside a randomized clinical trial. The rate of adverse events was lower and the cooling rate was faster than in clinical trials published.