Progress in the study of the cerebral protective effect of target temperature management in cardiac arrest patients

doi:10.3877/cma.j.issn.2095-123X.2022.05.011

Abstract

Abstract:

Targeted temperature management (TTM) is a therapeutic approach to temperature management according to a set protocol that is widely used in patients resuscitated successfully from cardiac arrest. In recent years, there have been significant advances in clinical practice studies on the cerebral protective effects of TTM in cardiac arrest patients, while it is also controversial from many sides. Different studies have different conditions such as the inclusion population, the hypothermia induction technique adopted and the time of reaching the target temperature for treatment. Moreover, the clinical trials do not fully simulate the complete and standard conditions of the basic trials, which will be subject to various restrictions in the actual application of TTM. This article reviews the research progress of TTM on brain protection in patients with cardiac arrest.

Key words: Target temperature management, Cardiac arrest, Hypothermia, Cerebral protection

Liting Yang, Dongfeng Pan, Xue Bai, Ling Zhang, Mengfei Chen. Progress in the study of the cerebral protective effect of target temperature management in cardiac arrest patients[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(05): 310-314.

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References 34

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作者	文献题目	期刊	发表时间	观点	结论
Nolan等^[2]	Therapeutic hypothermia after cardiac arrest. An advisory statement by the Advancement Life support Task Force of the International Liaison committee on Resuscitation	Resuscitation	2003年	有效	推荐将发生OHCA后自主循环恢复但意识尚未恢复患者的体温降至33~34℃、持续12~24 h
Hypothermia after Cardiac Arrest Study Group^[15]	Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest	N Engl J Med	2002年	有效	在因心室颤动导致心脏骤停并成功复苏的患者中，TTM提高了神经系统预后并降低了死亡率
Bernard等^[16]	Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia	N Engl J Med	2002年	有效	中度低温治疗可以改善OHCA复苏成功患者的预后
Nielsen等^[17]	Targeted temperature management at 33℃ versus 36℃ after cardiac arrest	N Engl J Med	2013年	无效	在心脏原因引起的OHCA昏迷患者中，与36℃的目标温度相比，33℃的低温处理并没有带来益处
Nolan等^[18]	European resuscitation council and european society of intensive care medicine 2015 guidelines for post-resuscitation care	Intensive Care Med	2015年	无效	TTM仍然很重要，但现在可以选择目标温度为36℃，而不是之前推荐的32~34℃
Dankiewicz等^[19]	Hypothermia versus normothermia after out-of-hospital cardiac arrest	N Engl J Med	2021年	无效	在OHCA患者中，与正常温度治疗相比，靶向低温治疗并未降低6个月的死亡率
Arrich等^[20]	Targeted temperature management after cardiac arrest. A systematic review and meta-analysis of animal studies	Resuscitation	2021年	有效	与常温相比，32~36℃范围内的TTM以及更短的冷却时间与TTM效应大小的增加独立相关
Cariou等^[22]	Targeted temperature management in the ICU: guidelines from a French expert panel	Ann Intensive Care	2017年	有效	TTM可以增加OHCA患者远期生存率

作者	文献题目	期刊	发表时间	观点	结论
Nolan等^[2]	Therapeutic hypothermia after cardiac arrest. An advisory statement by the Advancement Life support Task Force of the International Liaison committee on Resuscitation	Resuscitation	2003年	有效	推荐将发生OHCA后自主循环恢复但意识尚未恢复患者的体温降至33~34℃、持续12~24 h
Hypothermia after Cardiac Arrest Study Group^[15]	Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest	N Engl J Med	2002年	有效	在因心室颤动导致心脏骤停并成功复苏的患者中，TTM提高了神经系统预后并降低了死亡率
Bernard等^[16]	Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia	N Engl J Med	2002年	有效	中度低温治疗可以改善OHCA复苏成功患者的预后
Nielsen等^[17]	Targeted temperature management at 33℃ versus 36℃ after cardiac arrest	N Engl J Med	2013年	无效	在心脏原因引起的OHCA昏迷患者中，与36℃的目标温度相比，33℃的低温处理并没有带来益处
Nolan等^[18]	European resuscitation council and european society of intensive care medicine 2015 guidelines for post-resuscitation care	Intensive Care Med	2015年	无效	TTM仍然很重要，但现在可以选择目标温度为36℃，而不是之前推荐的32~34℃
Dankiewicz等^[19]	Hypothermia versus normothermia after out-of-hospital cardiac arrest	N Engl J Med	2021年	无效	在OHCA患者中，与正常温度治疗相比，靶向低温治疗并未降低6个月的死亡率
Arrich等^[20]	Targeted temperature management after cardiac arrest. A systematic review and meta-analysis of animal studies	Resuscitation	2021年	有效	与常温相比，32~36℃范围内的TTM以及更短的冷却时间与TTM效应大小的增加独立相关
Cariou等^[22]	Targeted temperature management in the ICU: guidelines from a French expert panel	Ann Intensive Care	2017年	有效	TTM可以增加OHCA患者远期生存率

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