在没有使用冷却装置的情况下,心脏骤停患者的突破性发烧
Grigory Ostrovskiy1, Sarah E Nelson2
1Department of Neurosurgery, Mount Sinai Health System, New York, New York; Division of Neurocritical Care, Departments of Neurology and Emergency Medicine, Hackensack University Medical Center, Hackensack, New Jersey; Departments of Neurology, Neurosurgery & Emergency Medicine, Hackensack Meridian School of Medicine, NJ.
The Journal of emergency medicine
|June 26, 2025
概括
在心脏骤停后避免发烧至关重要. 虽然冷却设备有助于预防发烧,但实现正常热量对于患者的生存和神经恢复更为关键.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 神经学 神经学
背景情况:
- 建议在心脏骤停后控制发烧.
- 冷却装置并不总是使用,即使正常热量是目标.
- 心脏骤停后发烧的发生率和影响需要进一步调查.
研究的目的:
- 为了确定心脏骤停后发烧的发生率.
- 评估发烧和临床结果之间的关联.
- 评估冷却设备在预防发烧和患者预后中的作用.
主要方法:
- 对接受重症监护单位 (ICU) 的成人心脏骤停幸存者的回顾性分析.
- 收集的数据包括冷却装置的使用,温度监测 (Tmax ≥38°C在48小时内),以及放电时的格拉斯哥昏迷表 (GCS) 评分.
- 统计分析包括单变量和多变量方法来确定结果的预测因素.
主要成果:
- 在194名分析患者中,49.7%接受了冷却装置,25.3%发烧 (Tmax ≥38°C).
- 没有冷却设备的患者发烧的发病率明显高 (37.1%对13.5%).
- 没有使用冷却装置是患病后发烧的最强有力的预测因素,而较高的GCS得分预测了生存和有利的神经结果.
结论:
- 冷却装置与降低发烧率有关,但在预后较差的患者中更频繁地使用.
- 实现避免发烧,而不是仅仅依赖于冷却设备的使用,似乎更为关键,以改善心脏骤停后的患者预后.
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