Current Advances in the Use of Therapeutic Hypothermia.
Current Advances in the Use of Therapeutic Hypothermia.
复制标题
低温治疗应用的最新进展。
DOI：
10.1089/ther.2019.29070.jjl
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发表时间：
2020
影响因子：
1.2
通讯作者：
Lyden,Patrick
中科院分区：
文献类型：
--
作者：
Lundbye,Justin;Badjatia,Neeraj;Polderman,KeesH;Lyden,Patrick
在迈阿密举行的2019年治疗性低温和温度管理研讨会上，介绍了几场关于治疗性低温使用的最新进展的最新讲座。大沃特伯里健康网络首席医疗官Justin Lundbye博士主持了关于在临床前研究中使用低温的各种治疗窗口以及在临床护理中使用预防性抗体治疗和其他方法的会议。马里兰大学医学院的Neeraj Badjatia博士利用神经危重症护理协会最新的循证指南，谈到了目标温度管理的实施。英国安格利亚鲁斯金医学院的Kees Polderman博士报告了治疗性低温和靶向温度管理对心肌功能和心肌电生理的有益作用。最后，雪松-西奈医学中心神经内科的Patrick Lyden博士对急性中风患者使用靶向温度管理和溶血栓治疗的血管内冷却治疗2 （ICTUS 2）试验的分析进行了有趣的讨论。每一个报告都很受欢迎，并在与会者之间引发了热烈的讨论。基斯·h·波尔德曼：帕特，这是一个非常有趣的理论，它有一定的道理，但也有一些缺点，因为24小时的冷却时间并不完全是凭空产生的。这是基于驱动缺血/再灌注在48小时内发生的过程。在老鼠身上，我们知道神经兴奋性毒性是非常重要的，它是一件关键的事情，它开始得很快，持续的时间不长。但在人类中，其他长效机制，如神经炎症，可能更重要。我们不知道哪些机制是关键，哪些机制不是，但如果神经炎症或细胞凋亡等机制更重要（在非大鼠中很可能是这种情况），那么我们就需要延长而不是缩短冷却时间。所以你可能是对的，但这不是必然的。
During the 2019 Therapeutic Hypothermia and Temperature Management Symposium in Miami, several state-of-theart lectures on current advances in the use of therapeutic hypothermia were presented. Dr. Justin Lundbye, Chief Medical Officer at The Greater Waterbury Health Network, moderated the sessions on various therapeutic windows for the use of hypothermia in preclinical studies as well as the use of prophylactic antibody treatment and other approaches used in clinical care. Dr. Neeraj Badjatia from the University of Maryland School of Medicine spoke on the implementation of targeted temperature management utilizing the latest evidencebased guidelines from the Neurocritical Care Society. Dr. Kees Polderman from the Anglia Ruskin School of Medicine in the United Kingdom reported on the beneficial effects of therapeutic hypothermia and targeted temperature management on myocardial function and myocardial electrophysiology. Finally, Dr. Patrick Lyden Department of Neurology, Cedars-Sinai Medical Center, provided an interesting discussion on an analysis of the Intravascular Cooling in the Treatment of Stroke 2 (ICTUS 2) trial utilizing targeted temperature management with thrombolytic therapy in acute stroke patients. Each of these presentations was well received and led to animated discussions among the attendees of the conference.Dr. Kees H. Polderman: Pat, really interesting theory and it has a ring of truth, but a little pushback because the 24-hour time period for cooling does not totally come out of thin air. This is based on the processes that drive ischemia/reperfusion that take place over a period of* 48 hours. In rats, we know that neuroexcitotoxicity is very important, it is a key thing and that is one that starts quickly and does not last that long. But in humans, other longer acting mechanisms such as neuroinflammation may be more important. We have no idea which mechanisms are key and which mechanisms are not, but if mechanisms such as neuroinflammation or apoptosis are more important (which might well be the case in nonrats), then we would need to extend rather than shorten the cooling time. So you might be right but it is not a certainty.
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