在急性肝衰竭中不受控制的内高血压的中度低温
R Jalan1, S W O Damink, N E Deutz
1Liver Unit, Royal Infirmary of Edinburgh, UK. r.jalan@ed.ac.uk
Lancet (London, England)
|October 8, 1999
概括
中度低温有效降低急性肝衰竭患者的内压力,为肝移植提供潜在的桥梁. 这种治疗有望改善关键病例的治疗结果.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 神经临界护理是指神经临界护理.
- 关键护理医学 关键护理医学
背景情况:
- 急性肝衰竭 (ALF) 具有很高的死亡风险,特别是当由内压力 (ICP) 增加而复杂时.
- 标准的治疗方法,如曼尼托尔和超过,对于ALF中不受控制的ICP通常是不够的.
- 研究新的治疗策略对于改善ALF患者的存活率至关重要.
研究的目的:
- 评估中度低温症在ALF患者中管理不受控制的ICP的安全性和有效性.
- 为了确定低体温是否可以作为一座桥梁,用于正体肝移植 (OLT).
主要方法:
- 七名耐火性增高ICP的ALF患者使用冷却毯子经历了中度低温 (核心温度为32-33°C).
- 根据OLT候选人 (8小时非候选人,候选人的前和内OLT) 患者被冷却了不同时间.
- 在冷却前后测量脑血流和代谢指数.
主要成果:
- 低温症显著减少了ICP从45到16mmHg (p<0.05) 和大脑血流的减少.
- 在低温期间,大脑输液压明显从45mmHg增加到70mmHg (p<0.05).
- 四名OLT候选人成功连接到移植;三名非候选人在重新加热后死亡. 没有注意到不良的低温效应.
结论:
- 中度低温是ALF中不受控制的ICP的安全和有效治疗方法.
- 低温可以作为关键的桥梁疗法,在精选的ALF患者中实现OLT.
- 进一步研究低温在ALF管理中的作用是有必要的.
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