Surface cooling for induction of mild hypothermia in conscious healthy volunteers - a feasibility trial 英文参考文献.docVIP

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Surface cooling for induction of mild hypothermia in conscious healthy volunteers - a feasibility trial 英文参考文献.doc

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Testorietal.CriticalCare2011,15:R248 /content/15/5/R248 RESEARCH OpenAccess Surfacecoolingforinductionofmild hypothermiainconscioushealthyvolunteers- afeasibilitytrial ChristophTestori1,FritzSterz1*,WilhelmBehringer1,AlexanderSpiel1,ChristaFirbas2andBerndJilma2 Abstract Introduction:Animalandhumanstudiessuggestbeneficialoutcomeeffectsofmildhypothermiaforstroke,for acutemyocardialinfarction,andforcardiogenicshock.Theaimofthisstudywastoinvestigatethefeasibilityand safetyofnon-invasivesurfacecoolingforinductionandmaintenanceofmildhypothermia(32to34°C)inhealthy, consciousvolunteers. Methods:Thetrialwassetataclinicalresearchwardinatertiarycarecenter,andincluded16healthymale volunteers18to70yearsold.Surfacecoolingwasestablishedbyanovelnon-invasivecoolingpadwithan esophagealtargettemperatureof32to34°Candmaintenanceforsixhours.Shivering-controlwasachievedwith meperidineandbuspironeandadditionaladministrationofmagnesiumineightsubjects. Results:Theprimaryendpointtoreachatargettemperatureof32to34°Cwasonlyreachedin6ofthe16 participatingsubjects.Temperaturesbelow35°Cwerereachedafteramediancoolingtimeof53minutes(38to 102minutes).Coolingratewas1.1°C/h(0.7to1.8°C).Additionaladministrationofmagnesiumhadnoinfluenceon coolingrate.Atnotimeduringthecoolingproceduredidtheparticipantsreportuncomfortableconditionsfor whichterminationofcoolinghadtobeconsidered.Nosevereskindamagewasreported. Conclusions:Coolingtobodytemperaturebelow35°Cbytheuseofnon-invasivesurfacecoolingisfeasibleand safeinconscioushealthyvolunteers.Furtherstudiesareneededtoinvestigateanalteredcoolingprotocolto achievetemperaturesbelow35°C. TrialRegistration:ISRCTN:ISRCTKeywords:humanexperimentation,hypothermia,magnesium,myocardialinfarction,safety,stroke,temperature Introduction So far, the majority of therapeutic hypothermia Therapeutic hypothermia improves neurological out- research has involved cardiac arrest patients, in whom comeandreducestheriskofdeathinpatientsaftercar- the induction and maintenan