吸入的对昏迷中心脏停止患者大脑白质损伤的影响:随机临床试验

Ruut Laitio ¹, Marja Hynninen ², Olli Arola ¹

¹Department of Anaesthesiology and Intensive Care, University of Turku, Turku, Finland2Division of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital, Turku, Finland.
²Division of Intensive Care Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki, Helsinki, Finland4Division of Intensive Care Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki.
³Department of Radiology, University of Turku, Turku, Finland6Turku University Hospital, Turku, Finland.
⁴Department of Medical Physics, Turku University Hospital, Turku, Finland8University of Turku, Turku, Finland.
⁵Turku University Hospital, Turku, Finland9Division of Clinical Neurosciences, University of Turku, Turku, Finland.
⁶Department of Neurology, University of Helsinki, Helsinki, Finland11Department of Neurology, Helsinki University Hospital, Helsinki, Finland.
⁷Turku University Hospital, Turku, Finland12Heart Center, University of Turku, Turku, Finland.
⁸Department of Radiology, University of Helsinki, Helsinki, Finland14Department of Radiology, Helsinki University Hospital, Helsinki, Finland.
⁹Emergency Medicine, Department of Emergency Medicine and Services, University of Helsinki, Helsinki, Finland16Emergency Medicine, Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland.
¹⁰Department of Cardiology, University of Helsinki, Helsinki, Finland18Department of Cardiology, Helsinki University Hospital, Helsinki, Finland.
¹¹Department of Anesthesia and Perioperative Care, University of California, San Francisco.
¹²Department of Biostatistics, University of Turku, Turku, Finland.

⁰Department of Anaesthesiology and Intensive Care, University of Turku, Turku, Finland2Division of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital, Turku, Finland.

概括

科学领域

神经科学
临床医学
放射学

背景情况

临床前研究表明,对缺氧缺血性脑损伤具有神经保护作用.
人类对预防大脑损伤的有效性研究有限.
在医院外心脏骤停 (OHCA) 的幸存者面临二次脑损伤的风险.

研究的目的

使用磁共振成像 (MRI) 评估吸入的对缺血白质损伤的影响.
评估使用和低温治疗的OHCA幸存者的神经结果和死亡率.

主要方法

一个随机的,单盲的,第二阶段临床试验,涉及110名昏迷的OHCA幸存者.
患者接受了24小时的低温 (33°C) 或单独低温的吸入式.
通过扩散张力MRI (微分异位) 评估白质损伤;神经学结果和死亡率是次要终点.

主要成果

克森组的总分离异性变异率增加了3. 8%,表明白质损伤较小 (P=. 006).
在6个月后,两组之间没有观察到神经结果 (修改的兰金表) 的显著差异.
在异组中观察到6个月死亡率下降的趋势 (调整后的危险率为0.49;P=.053).

结论

与单独的低温相比,吸入的与低温相结合会减少OHCA幸存者的白质损伤.
这项研究没有显示出神经结果或死亡率的统计学上显著改善.
为了验证这些初步发现并评估临床疗效,需要进行更大规模,更强大的试验.

吸入的对昏迷中心脏停止患者大脑白质损伤的影响:随机临床试验

概括

科学领域

背景情况

研究的目的

主要方法

主要成果

结论

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吸入的对昏迷中心脏停止患者大脑白质损伤的影响:随机临床试验

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概括

科学领域

背景情况

研究的目的

主要方法

主要成果

结论

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