重症监护室常见病症的体温管理研究现状

李 硕思1, 宋 娟1, 熊 波2
1、上海中医药大学附属普陀医院急诊重症监护室
2、上海市宝山区中西医结合医院药剂科

摘要


体温作为人体的一项基本生命体征,对疾病的发生、进展变化及临床治疗都有不可替代的作用。对于患者体温的监控
是重症医护人员临床工作的一项重要内容,然而对于不同的疾病,其对体温的管控要求是不尽相同的,其中对于心脏骤停、脓
毒症、接受 CRRT 治疗、颅脑损伤、围术期患者的病情康复甚至预后起着重要作用。文章旨在综合重症监护室内常见病症的体
温管理的相关研究,对上述常见疾病对体温管控要求作一概述,以了解目前体温管理在 ICU 临床工作中的理论依据和研究现状。

关键词


重症监护室 ;体温管理 ;心脏骤停 ;脓毒症 ;CRRT ;颅脑损伤 ;围术期

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参考


[1]Taccone F S.High Quality Targeted Temperature

Management (TTM) After Cardiac Arrest[J].Critical Care,

2020, 24(1).DOI:10.1186/s13054-019-2721-1.

[2]Sadan O.Therapeutic Hypothermia in Critically

Ill Patients: The Role of Hypothermia in the Critical Care

Toolbox[J]. Critical Care Medicine, 2020,48(7):1089–1090.

[3]Ahmad M Omairi.Targeted Hypothermia

Temperature Management[J]. StatPearls [Internet],2022(5).

[4]Madden LK. The Implementation of Targeted

Temperature Management: An Evidence-Based Guideline

from the Neurocritical Care Society[J]. Neurocritical

Care,2017,27(3):468-487.

[5]John J Marini.Critical Care Medicine: The

Essentials and More[M]. Philadelphia:lippincott

williams&wilkins,2019:596-608.

[6] 刘大为 . 重症治疗 : 群体化、个体化、器官化 [J].

中华内科杂志 ,2019,58 (5):337-341.

[7] 刘 大 为 . 重 症 医 学 [M]. 北 京 : 人 民 卫 生 出 版

社 ,2017:416.

[8]Hypothermia after Cardiac Arrest Study Group.Mild

therapeutic hypothermia to improve the neurologic outcome

after cardiac arrest[J].New England Journal of Medicine,

2002,346(8):549-556.

[9]Joseph E Parrillo.Critical Care Medicine:principles

of dlagnosis and management in the adult(fifth edition)[M].

Philadelphia:elsevier,2019:8.

[10]Nolan JP.European Resuscitation Council

and European Society of Intensive Care Medicine

guidelines 2021: post-resuscitation care[J]. Intensive Care

Med,2021(47):369-421.

[11]Jerry P Nolan.European Resuscitation Council

and European Society of Intensive Care Medicine

guidelines 2021: post-resuscitation care[J]. Intensive Care

Med,2021(47):369-421.

[12]John J Marini.Critical Care Medicine:

The Essentials and More[M].Philadelphia:lippincott

williams&wilkins,2019:434.

[13]Moskowitz A.In-hospital cardiac arrest:are we

overlooking a key distinction[J].Current Opinion in Critical

Care,2018,24(3):151-157.

[14]Maria Høybye.In-Hospital vs. Out-of-Hospital

Cardiac Arrest: Patient Characteristics and Survival[J].Resusc

itation,2021,1(158):157-165.

[15]Kirkegaard H.Targeted Temperature Management

for 48 vs 24 Hours and Neurologic Outcome After Out_xfffe_of-Hospital[J]. Cardiac Arrest,2017,25,318(4): 341–350.

[16]Abazi L. Long-term survival in out-of-hospital

cardiac arrest patients treated with targeted temperature

control at 33 ° C or 36 ° C: A national registry study[J].

Resuscitation,2019(143):142-147.

[17]Shiva P Ponamgi, Saraschandra Vallabhajosyula.

In adults with coma after out-of-hospital cardiac arrest,

hypothermia vs. normothermia did not reduce 6-mo

mortality[J]. Ann Intern Med,2021,174(11):126.

[18]Fernando SM. Targeted temperature management

following out-of-hospital cardiac arrest: a systematic

review and network meta-analysis of temperature targets[J].

Intensive Care Med,2021,47(10):1078-1088.

[19]Kushimoto S.Impact of Body Temperature

Abnormalities on the Implementation of Sepsis Bundles and

Outcomes in Patients With Severe Sepsis: A Retrospective

Sub-Analysis of the Focused Outcome Research on

Emergency Care for Acute Respiratory Distress Syndrome,

Sepsis and Trauma Study[J]. Crit Care Med,2019,47(5):691-

699.

[20] 袁丁 . 脓毒症休克的体温控制 [J]. 中西医结合

心血管病杂志 ,2016,4(19):11-12.

[21] 毛小强 . 体温高峰与重症监护室内脓毒症患

者预后的相关性 [J]. 温州医科大学学报 ,2018,48(8):582-

586.

[22]Yenari MA.Neuroprotective mechanisms

of hypothermia in brain ischaemia [J]. Nat Rev

Neurosci,2012(13):267-278.

[23]Fonseca MT, Rodrigues AC, Cezar LC, et al.

Spontaneous hypothermia in human sepsis is a transient,

self-limiting and non-terminal response [J]. J Appl Physiol

(1985),2016,120(12):1394-401.

[ 2 4 ] G a r a m i A . F e v e r a n d h y p o t h e r m i a i n

systemic inflammation[J]. Handbook of Clinical

Neurology,2018(157):565-597.

[25]Ding W. Therapeutic mild hypothermia improves

early outcomes in rats subjected to severe sepsis[J]. Life

Sciences,2018(199):1-9.

[26]Léon K. Effect of Induced Mild Hypothermia

on Acid-Base Balance During Experimental Acute Sepsis

in Rats[J]. Therapeutic Hypothermia and Temperature

Management,2015:5(3):163-170.

[27]Johansen ME.Mild induced hypothermia: effects

on sepsis-related coagulopathy - results from a randomized

controlled trial[J].Thromb Res,2015,35(1):175-82.

[28]Zhang Z.Antipyretic Therapy in Critically

Ill Patients with Sepsis: An Interaction with Body

Temperature[J].PLOS ONE,2015,10(3):1-11.

[29]Bell M,Ronco C,Hansson F,et al.Hypothermia

during CRRT, a comparative analysis[J].Acta

Anaesthesiologica Scandinavica,2020,64(8):1162-1166.

[30]AkhoundiA.Incidence of adverse events

during continuous renal replacement therapy[J].

BloodPurif,2015,39(4):333-339.

[31] 王道霞 , 吴克艳 . 重症患者持续性肾脏替代

治疗中低体温的护理干预 [J]. 国际移植与血液净化杂

志 ,2020,18(1):37-39.

[32]Xu Jiefeng. Early Initiation of Continuous Renal

Replacement Therapy Induces Fast Hypothermia and

Improves Post-Cardiac Arrest Syndrome in a Porcine

Model [J]. SHOCK, 2019,52(4), 456–467.

[33]Zaccaria Ric ci. Technical Complications of

Continuous Renal Replacement Therapy[J]. Contrib

Nephrol,2018(194):99-108.

[34]《加重继发性脑损伤危险因素防治专家共识》

专家组 . 颅脑创伤后加重继发性脑损伤的危险因素防治

专家共识 [J]. 临床神经外科杂志 ,2020,17(3):241-253.

[35] 中国医师协会急诊医师分会 , 中国医药教育协

会急诊医学专业委员会 , 成人急危重症脑损伤患者目标

温度管理临床实践专家共识组等 . 成人急危重症脑损伤

患者目标温度管理临床实践专家共识 [J]. 中华急诊医学

杂志 2019,28(3):282-291.

[36]Huang H.Effect of mild hypothermia on prognosis

of patients with severe traumatic brain injury: A metaanalysis with trial sequential analysis[J]. Australian Critical

Care. 2020,33(4):375-381.

[37]Cooper DJ. Effect of Early Sustained Prophylactic

Hypothermia on Neurologic Outcomes Among Patients

With Severe Traumatic Brain Injury[J]. JAMA,2018,320(21).

[38]Nina M Rzechorzek.A daily temperature rhythm

in the human brain predicts survival after brain injury[J].

Brain. 2022 Jun 13;awab466.

[39]Elisa Gouvea Bogossian.Fever management in

acute brain injury[J].Curr Opin Crit Care,2022,28(2):130-

137.

[40]Riley C,Andrzejowski J.Inadvertent perioperative

hypothermia[J]. BJA Education, 2018,18(8):227-233.

[41] 国家麻醉专业质量控制中心 , 中华医学会麻醉

学分会 . 围手术期患者低体温防治专家共识 (2017)[J]. 协

和医学杂志 , 2017, 8(6):352-358.

[42] 李娟 . 围手术期低体温控制对术后 PACU 出室

时间影响的研究 [J]. 麻醉安全与质控 (Perioperative Safety

and Quality Assurance),2020(5):297-300.

[43]Kim J H.Therapeutic Hypothermia in Critically

Ill Patients: A Systematic Review and Meta-Analysis

of High Quality Randomized Trials[J]. Crit Care

Med,2020,48(7):1047-1054.


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