室細動性心停止の現場選択的な脳冷却:PRINCESS2ランダム化試験のパイロット結果

Emelie Dillenbeck¹, Thomas Berthelsen^2,3, Ervigio Corral Torres⁴

¹Department of Clinical Science and Education, Center for Resuscitation Science, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden. emelie.dillenbeck@ki.se.

Critical care (London, England)

|February 12, 2026

まとめ

ショッキング可能なリズムを持つ病院外心停止 (OHCA) 患者の現場での鼻経冷却は,高いプロトコル遵守と安全性を示しました. この神経保護戦略は,神経学的回復を改善し,主治試験は計画通り継続する可能性があります.

科学分野:

神経学神経学とは
緊急医療緊急医療
心臓病学心臓病学

背景:

発血性再注血性脳損傷は,心停止後の重大な合併症である.
現在の神経保護療法は不足しています.
早期の選択的な脳冷却は,病院外心停止 (OHCA) 患者の神経学的回復を改善する可能性があります.

研究の目的:

OHCA患者の現場での鼻経冷却の安全性とプロトコルの遵守を評価する.
神経保護戦略として早期選択的な脳冷却を実施する可能性を評価する.
OHCA後の神経学的回復を調査する主要なPRINCESS2試験の準備のためです.

主な方法:

欧州の多センターPRINCESS2試験のパイロットフェーズでは,最初のショックリズムを持つ100人のOHCA患者を対象に実施した.
ランダム化により,鼻経冷却と,その後,全身性低体温または標準的な正常体温で発熱が制御されます.
治療分配の遵守,プロトコル遵守,および生存,再逮捕,および有害事象を含む安全性に関する評価.

主要な成果:

介入グループでは高いプロトコル遵守率 (92%) が達成されました.
デバイスに関連する深刻な有害事象は報告されていません.
72時間生存率と病院前の再逮捕率は,冷却群と対照群の間で類似していました.

結論:

現場での鼻経冷却は,衝撃的なリズムを持つOHCA患者にとって安全で実行可能な神経保護戦略です.
試験段階では,プロトコルの遵守が高く,主要なPRINCESS2試験の継続を支えたことが示されました.
早期の選択的な脳冷却は,心停止後の神経学的結果を改善する見込みを示しています.

キーワード:

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