在儿科心脏骤停后的低温治疗
Dermot R Doherty1, Christopher S Parshuram, Isabelle Gaboury
1Department of Anaesthesia, Division of Pediatric Intensive Care, Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, ON, Canada.
Circulation
|March 11, 2009
概括
在儿科心脏骤停后的低温疗法在调整后的分析中没有显示出显著的死亡率差异. 需要进一步的随机试验来确认这种重症监护干预的益处和危害.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 心血管研究研究心血管研究
- 治疗性低温症 治疗性低温症
背景情况:
- 低温疗法被证明可以改善心脏骤停和出生窒息后的成人和新生儿的结果.
- 在患有心脏骤停的儿科患者中,低温治疗的疗效仍未确定.
- 这项研究调查了低温治疗对儿科心脏骤停幸存者的影响.
研究的目的:
- 评估治疗性低温症在心脏骤停后儿童和婴儿的有效性和安全性.
- 为了确定低温治疗是否影响儿科心脏骤停患者的死亡率和功能结果.
主要方法:
- 一项回顾性研究分析了222名儿科患者的心脏骤停在五个中心超过两年.
- 资格标准包括怀孕后>40周至<18周的年龄,心脏骤停>3分钟,复苏后的生存时间>12小时.
- 29名患者接受了低温治疗 (目标温度为33.7°C,持续21小时);结果与接受正常热治疗的患者进行了比较.
主要成果:
- 接受低温治疗的患者心脏骤停时间较长,需要更多的干预措施.
- 未经调整的分析显示,低温组的死亡率更高 (P=0.009).
- 在对心脏骤停持续时间和ECMO使用等因素进行调整后,没有观察到死亡率 (P=0.502) 或组间不良事件的显著差异.
结论:
- 在高风险的儿科心脏骤停病例中给予治疗性低温,可能会混未经调整的结果.
- 经过调整后的分析未能证实或反驳低温治疗在这个人群中的益处.
- 随机对照试验对于最终评估小儿心脏骤停后低温治疗的益处和风险至关重要.
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