急性脑损伤的温度控制:一个更新
Victor Lin1, Cindy Tian2, Sarah Wahlster1,3,4
1Department of Neurology, University of Washington, Seattle, Washington.
Seminars in neurology
|April 9, 2024
概括
温度控制对于严重急性脑损伤 (SABI) 是至关重要的. 虽然预防发烧有利于所有SABI患者,但低温温度控制 (HTC) 的有效性因病情而异,需要进一步研究以找到最佳策略.
科学领域:
- 神经学 神经学
- 临界护理医学 临界护理医学
- 神经科学是一个神经科学.
背景情况:
- 发烧是严重急性脑损伤 (SABI) 的常见并发症,通过增加炎症和内压力 (ICP) 恶化神经结果.
- 温度管理,特别是低温温度控制 (HTC),正在探索通过减少大脑代谢需求和炎症来减轻这些不良影响.
研究的目的:
- 为各种SABI亚型的温度控制提供临床证据的概述.
- 分析HTC在不同严重急性脑损伤条件中的微妙有效性.
主要方法:
- 在SABI中对温度控制的临床证据的审查.
- 在创伤性脑损伤 (TBI),急性缺血性中风 (AIS),脑内出血 (ICH),动脉瘤下关节出血 (aSAH) 和心脏骤停后,分析与发烧和HTC相关的结果.
- 对儿科和新生儿群体的检查.
主要成果:
- 在SABI类型中,预防发烧始终是有益的.
- HTC显示有效性可变;在心脏骤停后的结果不一致,在TBI和AIS中发现混合结果.
- 在ICH,aSAH,细菌性脑膜炎和状态中,HTC的有效性也是可变的,在儿科缺氧-缺血性脑病变中注意到了显著的益处.
结论:
- 虽然SABI中温度控制的理由很强,但临床结果在亚型之间存在显著差异.
- 普遍推预防发烧,但HTC的应用和有效性需要进一步研究以确定最佳策略.
- 对于不同的严重急性脑损伤,需要对温度管理采取细微的方法.
相关概念视频
01:25Increased Body Temperature
666
A body temperature above 38°C (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in...
666
01:29Decreased Body Temperature
615
A decreased body temperature can occur in patients with hypothermia and frostbite. Heat loss with extended cold exposure overpowers the body's ability to create heat, resulting in hypothermia. Core temperature readings help classify hypothermia. Mild hypothermia is temperatures between 32 °C (89.6 °F) and 35°C (95 °F) and is caused by impaired thermoregulation. Moderate hypothermia is temperatures between 28 C (82.4 °F) and 32 °C (89.6 °F) caused by...
615