亞低溫技術(shù)在心肺復(fù)蘇中的應(yīng)用陸一鳴(1)-預(yù)覽頁
【正文】 hermia group (39%). 歐洲多中心臨床試驗（ HACA trial) ? 隨機將 275名患者分組為低溫或常溫兩組 ? 降溫時間：使用體表降溫降到 34度耗時 ? 結(jié)果： 低體溫 正常體溫 ? 好的結(jié)果 55% 39% p= ? 死亡率 41% 55% p= 每六個接受治療的患者， 有一個可救活！ Number needed to treat to achieve good neurological oute in one extra patient: 6 Holzer M et al., Crit Care Med 2022。 ? 前瞻性的，多中心研究 ? 對心搏停搏患者使用 ICY導(dǎo)管進行可行性和安全性評估 ? 多中心參加 : Henry Ford, Duke, University of Houston ? 歐洲復(fù)蘇理事會資助 30 多個中心參加，包括 500名患者，結(jié)果在 2022年 9月阿姆斯特丹會議上公布。 C。 odds ratio , 95% CI, to 。 adjusted odds ratio , to ). There was no difference in the rate of plications except for bradycardia. Conclusion Endovascular cooling improved survival and shortterm neurological recovery pared with standard treatment in atose adult survivors of cardiac arrest. Temperature control was effective and safe with this device. An advisory statement by the Advanced Life Support Task Force of the International Liaison Committee on Resuscitation (ILCOR – includes AHA) (Published in Resuscitation, June 2022 and Circulation, July 2022) ?對于無知覺的具有自發(fā)循環(huán)的門急診心臟驟?；颊?，如果出現(xiàn)最初室顫節(jié)律，則應(yīng)該將該患者體溫降到 3234度達 1224小時。56:913。 Polderman et al. Critical Care Med 2022。 C 復(fù)溫階段Rewarm Phase 維持階段 嚴(yán)格控制在 3234度 緩慢，可控的復(fù)溫以免顱內(nèi)壓反彈 必須能夠完全控制 3個階段 Temperature Profile Using Icy? Catheter (Cooling time: 98 minutes） 32333435363738390 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45T i m e af t e r R O SC [ hou r s ]Temp [176。 346:549–556 vs. 346:557–563) ? ? Target temperature? 33 degrees or 35 degrees Celsius? ? How rapidly should warming take place? ? Is therapeutic hypothermia efficacious for patients with initial rhythms other than ventricular fibrillation? ? Can we differentiate those patients who will benefit from mild hypothermia and those who will not? Still a lot of questions… Prognostic indicators ? In a metaanalysis of 11 studies involving almost 2022 patients in cardiac arrest, there were no immediate clinical signs to predict neurologic oute. ? The best clinical signs : absent corneal reflexes at 24 h
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