在心脏骤停后患者的目标温度管理过程中影响目标温度偏差的因素
Kanae Ochiai1,2, Yasuhiro Otomo3,4
1Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital, Bunkyo-ku, Tokyo, Japan kana_hina_kiss@yahoo.co.jp.
Open heart
|December 15, 2023
概括
使用35°C的修改目标温度管理 (TTM) 协议对心脏骤停后患者有效. 温度偏差没有影响结果,但神经肌肉阻断剂等因素影响了它们.
科学领域:
- 心脏病学 心脏病学
- 密集护理医学 密集护理医学
- 神经学 神经学
背景情况:
- 针对性温度管理 (TTM) 对心脏骤停后患者至关重要.
- 保持最佳温度至关重要,因为高温会使结果恶化,过冷会增加并发症.
- 机构已经修改了TTM协议,我们在2017年采用了35°C的目标.
研究的目的:
- 将传统的TTM与修改的35°C协议进行比较.
- 评估温度偏差对患者结果 (死亡率,神经系统) 的影响.
- 确定影响TTM期间温度偏差的因素.
主要方法:
- 单中心,对成人出院心脏骤停患者的回顾性观察性研究.
- 传统与修改的TTM协议的比较 (2017年后).
- 对温度偏差 (>±0.5°C,>37°C,<33°C) 和影响因素的分析.
主要成果:
- 修改后的协议显示了显著更高的TTM性能率.
- 常规组中温度偏差更频繁;修改组需要更多的神经肌肉阻断剂 (NMBA).
- 并发症,死亡率或神经结果没有显著差异;温度偏差没有影响结果.
结论:
- 对于TTM来说,35°C的目标是可以接受的,并且可以通过适当的NMBA用于控制来实现.
- 在TTM期间的温度偏差没有影响患者的结果.
- 了解影响温度偏差的因素有助于优化TTM质量.
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