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首页> 外文期刊>Circulation journal >Early induction of hypothermia during cardiac arrest improves neurological outcomes in patients with out-of-hospital cardiac arrest who undergo emergency cardiopulmonary bypass and percutaneous coronary intervention.
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Early induction of hypothermia during cardiac arrest improves neurological outcomes in patients with out-of-hospital cardiac arrest who undergo emergency cardiopulmonary bypass and percutaneous coronary intervention.

机译：在心脏骤停期间尽早诱导体温过低可以改善急诊体外循环和经皮冠状动脉介入治疗的院外心脏骤停患者的神经功能。

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BACKGROUND: Therapeutic hypothermia for comatose survivors of out-of-hospital cardiac arrest has demonstrated neurological benefits. Although early cooling during cardiac arrest enhances efficacy in animal studies, few clinical studies are available. METHODS AND RESULTS: The 171 patients who failed to respond to conventional cardiopulmonary resuscitation were studied prospectively. Patients underwent emergency cardiopulmonary bypass (CPB) plus intra-aortic balloon pumping, with subsequent percutaneous coronary intervention (PCI) if needed. Mild hypothermia (34 degrees C for 3 days) was induced during cardiac arrest or after return of spontaneous circulation. Of the 171 patients, 21 (12.3%) had a favorable neurological outcome at hospital discharge. An unadjusted rate of favorable outcome decreased in a stepwise fashion for increasing quartiles of collapse-to-34 degrees C interval (P=0.016). An adjusted odds ratio for favorable outcome after collapse-to-CPB interval was 0.89 (95% confidence interval (CI) 0.82-0.97) and after CPB-to-34 degrees C interval, 0.99 (95%CI 0.98-0.99) when collapse-to-34 degrees C interval was divided into 2 components. Favorable neurological accuracy of a collapse-to-CPB interval at a cutoff of 55.5 min and CPB-to-34 degrees C interval at a cutoff of 21.5 min was 85.4% and 89.5%, respectively. CONCLUSIONS: Early attainment of a core temperature had neurological benefits for patients with out-of-hospital cardiac arrest who underwent CPB and PCI. (Circ J 2010; 74: 77 - 85).
机译：背景：院外心脏骤停昏迷幸存者的低温治疗已显示出神经学益处。尽管心脏骤停期间的早期降温可增强动物研究的功效，但几乎没有临床研究可用。方法与结果：前瞻性研究了171例常规心肺复苏失败的患者。患者接受了紧急体外循环（CPB）加上主动脉内球囊抽吸，并在需要时进行随后的经皮冠状动脉介入治疗（PCI）。在心脏骤停期间或自发循环恢复后，出现轻度的体温过低（34摄氏度，持续3天）。在171例患者中，有21例（12.3％）出院时神经系统预后良好。随着塌陷至34摄氏度区间的四分位数增加，未调整的有利结局率以逐步的方式降低（P = 0.016）。坍塌至CPB间隔后有利结果的调整比值比为0.89（95％置信区间（CI）0.82-0.97），CPB到34°C间隔后为0.99（95％CI 0.98-0.99）至34℃的间隔分为2个成分。在55.5分钟的临界值处崩溃至CPB间隔和在21.5分钟的临界值处CPB至34摄氏度的神经学准确性分别为85.4％和89.5％。结论：早期达到中心温度对接受CPB和PCI的院外心脏骤停患者具有神经学益处。 （Circ J 2010; 74：77-85）。

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