2017年10月16日,美国神经重症监护学会(Neurocritical Care Society,NCS)发布了目标温度管理(targeted temperature management,TTM)实施循证指南(以下称2017 NCS指南)。指南编辑委员会基于人群-干预-比较-结果(population-intervention...2017年10月16日,美国神经重症监护学会(Neurocritical Care Society,NCS)发布了目标温度管理(targeted temperature management,TTM)实施循证指南(以下称2017 NCS指南)。指南编辑委员会基于人群-干预-比较-结果(population-intervention-comparison-outcome,PICO),针对TTM的诱发和维持、寒战和并发症这3个方面、共16个相关临床问题进行了阐述与讨论。2017 NCS指南旨在协助采用TTM手段进行监护的神经重症监护医师更好地开展TTM。同时,本文在对2017 NCS指南进行解读的基础上,将该指南与2017年法国重症监护室TTM指南、2015年加拿大心脏骤停后TTM指南、2016年中国心脏骤停后目标温度管理专家共识和2015年神经重症低温治疗中国专家共识进行比较和分析,以帮助临床医师更好地了解TTM在神经重症监护中的应用进展。展开更多
Targeted temperature management(TTM) shows the most promising neuroprotective therapy against hypoxic/ischemic encephalopathy(HIE).In addition, TTM is also useful for treatment of elevated intracranial pressure(ICP).H...Targeted temperature management(TTM) shows the most promising neuroprotective therapy against hypoxic/ischemic encephalopathy(HIE).In addition, TTM is also useful for treatment of elevated intracranial pressure(ICP).HIE and elevated ICP are common catastrophic conditions in patients admitted in Neurologic intensive care unit(ICU).The most common cause of HIE is cardiac arrest.Randomized control trials demonstrate clinical benefits of TTM in patients with post-cardiac arrest.Although clinical benefit of ICP control by TTM in some specific critical condition, for an example in traumatic brain injury, is still controversial, efficacy of ICP control by TTM is confirmed by both in vivo and in vitro studies.Several methods of TTM have been reported in the literature.TTM can apply to various clinical conditions associated with hypoxic/ischemic brain injury and elevated ICP in Neurologic ICU.展开更多
文摘2017年10月16日,美国神经重症监护学会(Neurocritical Care Society,NCS)发布了目标温度管理(targeted temperature management,TTM)实施循证指南(以下称2017 NCS指南)。指南编辑委员会基于人群-干预-比较-结果(population-intervention-comparison-outcome,PICO),针对TTM的诱发和维持、寒战和并发症这3个方面、共16个相关临床问题进行了阐述与讨论。2017 NCS指南旨在协助采用TTM手段进行监护的神经重症监护医师更好地开展TTM。同时,本文在对2017 NCS指南进行解读的基础上,将该指南与2017年法国重症监护室TTM指南、2015年加拿大心脏骤停后TTM指南、2016年中国心脏骤停后目标温度管理专家共识和2015年神经重症低温治疗中国专家共识进行比较和分析,以帮助临床医师更好地了解TTM在神经重症监护中的应用进展。
基金the National Research University Project of Thailand from Office of Higher Education Commission and Center of Excellence in Integrated Sciences for Holistic Stroke Research from Thammasat University
文摘Targeted temperature management(TTM) shows the most promising neuroprotective therapy against hypoxic/ischemic encephalopathy(HIE).In addition, TTM is also useful for treatment of elevated intracranial pressure(ICP).HIE and elevated ICP are common catastrophic conditions in patients admitted in Neurologic intensive care unit(ICU).The most common cause of HIE is cardiac arrest.Randomized control trials demonstrate clinical benefits of TTM in patients with post-cardiac arrest.Although clinical benefit of ICP control by TTM in some specific critical condition, for an example in traumatic brain injury, is still controversial, efficacy of ICP control by TTM is confirmed by both in vivo and in vitro studies.Several methods of TTM have been reported in the literature.TTM can apply to various clinical conditions associated with hypoxic/ischemic brain injury and elevated ICP in Neurologic ICU.
