在心室动心脏骤停的现场选择性脑冷却:PRINCESS2随机试验的试点结果
Emelie Dillenbeck1, Thomas Berthelsen2,3, Ervigio Corral Torres4
1Department of Clinical Science and Education, Center for Resuscitation Science, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden. emelie.dillenbeck@ki.se.
Critical care (London, England)
|February 12, 2026
概括
现场透鼻冷却在医院外心脏骤停 (OHCA) 患者与可震动的节律显示了高的协议遵守和安全. 这种神经保护策略可以改善神经恢复,主要试验将按计划继续进行.
科学领域:
- 神经学 神经学
- 紧急医疗 紧急医疗
- 心脏病学 心脏病学
背景情况:
- 缺血-再输血性脑损伤是心脏骤停后的一个重要并发症.
- 目前缺乏神经保护疗法.
- 早期选择性脑冷却可以改善非医院心脏骤停 (OHCA) 患者的神经恢复.
研究的目的:
- 评估OHCA患者现场过鼻冷却的安全性和协议遵守.
- 评估实施早期选择性脑冷却作为神经保护策略的可行性.
- 为了准备主要的PRINCESS2试验,研究OHCA后的神经恢复.
主要方法:
- 欧洲多中心PRINCESS2试验的试点阶段涉及100名OHCA患者,他们最初的心律可能受到冲击.
- 随机选择通过鼻腔冷却,然后进行全身低温或标准正常热,并控制发烧.
- 评估治疗分配的坚持,协议的遵守和安全结果,包括生存,重新逮捕和不良事件.
主要成果:
- 干预组在干预组中实现了高度的协议遵守 (92%).
- 没有报告与设备相关的严重不良事件.
- 在冷却和对照组之间,72小时的生存率和医院前再逮捕率相似.
结论:
- 在现场通过鼻子冷却是OHCA患者的安全和可行的神经保护策略,因为OHCA患者的节律很容易受到冲击.
- 试点阶段证明了高度遵守协议,支持继续主PRINCESS2试验.
- 早期选择性脑冷却显示出改善心脏骤停后神经结果的前景.
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