Circulation:低温治疗在心脏骤停治疗中的作用

2016-09-15 MedSci MedSci原创

大量研究表明即使被医护人员成功抢救的心脏骤停患者,复苏后常有严重的神经系统损伤。另外,相关的实验性和临床观察性的研究结果表明,在在心肺复苏术(CPR)时,同时进行低温治疗可能会改善心脏骤停患者神经系统的预后。

大量研究表明即使被医护人员成功抢救的心脏骤停患者,复苏后常有严重的神经系统损伤。另外,相关的实验性和临床观察性的研究结果表明,在心肺复苏术(CPR)时,同时进行低温治疗可能会改善心脏骤停患者神经系统的预后。在CPR时进行的低温治疗是通过给心脏骤停患者快速静脉补充大量冷晶体液的方式来实现。来自澳大利亚墨尔本莫纳什大学流行病学与预防医学的史蒂芬A.伯纳德及其团队对CPR时进行的低温治疗的临床意义进行了研究,并将研究成果发表于心血管领域顶级期刊《Circulation》上。

在这项多中心、随机对照的研究中,研究者将纳入研究的心脏骤停患者,随机分配入快速静脉滴注2 L冷盐水组或标准护理组。主要研究终点为心脏骤停患者出院时的生存情况,次要终点为自主循环的恢复情况。由于受大多数医院的温度管理的变化,使得该研究提早结束(完成了48%研究目标)。 

基于完成的研究数据表明:纳入研究的1198例患者,618例患者在CPR时接受了低温治疗,580例接受了标准的院前急救护理。低温治疗组的患者每人平均输入1193±647毫升冷盐水。与标准治疗相比,接受低温治疗的心脏骤停患者自主循环恢复率明显降低(41.2%50.6%P = 0.03相比);另外,低温治疗组的总体出院率为10.2%,而标准治疗组为11.4%P = 0.71)。最终结果表明在成人院外心脏骤停时,使用快速大量输注低温治疗无法改善心脏骤停患者出院率,但复苏时低温治疗可降低患者的自主循环恢复率 

原始出处:

Stephen A, et al. Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline. Circulation. 2016 Sep 13;134(11):797-805.

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    2016-09-19 lhl629

    很好的内容,谢谢分享。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=130792, encodeId=aafd130e9289, content=很好的内容,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Mon Sep 19 14:56:00 CST 2016, time=2016-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129808, encodeId=070b129808f9, content=很好的内容,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Sun Sep 18 05:08:00 CST 2016, time=2016-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129232, encodeId=1ed812923266, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Sep 17 10:53:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129233, encodeId=0c3a12923313, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Sep 17 10:53:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395220, encodeId=a490139522068, content=<a href='/topic/show?id=589f26255b3' target=_blank style='color:#2F92EE;'>#低温治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26255, encryptionId=589f26255b3, topicName=低温治疗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/C4Qhy5XHSe503Qbjzc1UtDR83BCv66o6P2XRedX9ohsNGa3uEVicFFk2qkuX5zBSmpicepFySBrwoYknhqMdKmtw/132, createdBy=1aca2500179, createdName=12498d2fm51(暂无昵称), createdTime=Sat Sep 17 06:20:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129009, encodeId=dc491290091e, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sat Sep 17 00:02:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129008, encodeId=708b1290085d, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sat Sep 17 00:01:00 CST 2016, time=2016-09-17, status=1, ipAttribution=)]
    2016-09-18 lhl629

    很好的内容,谢谢分享。

    0

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    2016-09-17 doctorJiangchao

    继续学习

    0

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    2016-09-17 doctorJiangchao

    继续关注

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=130792, encodeId=aafd130e9289, content=很好的内容,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Mon Sep 19 14:56:00 CST 2016, time=2016-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129808, encodeId=070b129808f9, content=很好的内容,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Sun Sep 18 05:08:00 CST 2016, time=2016-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129232, encodeId=1ed812923266, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Sep 17 10:53:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129233, encodeId=0c3a12923313, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Sep 17 10:53:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395220, encodeId=a490139522068, content=<a href='/topic/show?id=589f26255b3' target=_blank style='color:#2F92EE;'>#低温治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26255, encryptionId=589f26255b3, topicName=低温治疗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/C4Qhy5XHSe503Qbjzc1UtDR83BCv66o6P2XRedX9ohsNGa3uEVicFFk2qkuX5zBSmpicepFySBrwoYknhqMdKmtw/132, createdBy=1aca2500179, createdName=12498d2fm51(暂无昵称), createdTime=Sat Sep 17 06:20:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129009, encodeId=dc491290091e, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sat Sep 17 00:02:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129008, encodeId=708b1290085d, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sat Sep 17 00:01:00 CST 2016, time=2016-09-17, status=1, ipAttribution=)]
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    2016-09-17 知难而进

    继续关注!

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  7. [GetPortalCommentsPageByObjectIdResponse(id=130792, encodeId=aafd130e9289, content=很好的内容,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Mon Sep 19 14:56:00 CST 2016, time=2016-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129808, encodeId=070b129808f9, content=很好的内容,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Sun Sep 18 05:08:00 CST 2016, time=2016-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129232, encodeId=1ed812923266, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Sep 17 10:53:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129233, encodeId=0c3a12923313, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Sep 17 10:53:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395220, encodeId=a490139522068, content=<a href='/topic/show?id=589f26255b3' target=_blank style='color:#2F92EE;'>#低温治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26255, encryptionId=589f26255b3, topicName=低温治疗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/C4Qhy5XHSe503Qbjzc1UtDR83BCv66o6P2XRedX9ohsNGa3uEVicFFk2qkuX5zBSmpicepFySBrwoYknhqMdKmtw/132, createdBy=1aca2500179, createdName=12498d2fm51(暂无昵称), createdTime=Sat Sep 17 06:20:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129009, encodeId=dc491290091e, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sat Sep 17 00:02:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129008, encodeId=708b1290085d, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sat Sep 17 00:01:00 CST 2016, time=2016-09-17, status=1, ipAttribution=)]
    2016-09-17 知难而进

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