Too cold may not be so cool spontaneous hypothermia as a marker of poor outcome after cardiac arrest 英文参考文献.docVIP

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Too cold may not be so cool spontaneous hypothermia as a marker of poor outcome after cardiac arrest 英文参考文献.doc

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Too cold may not be so cool spontaneous hypothermia as a marker of poor outcome after cardiac arrest 英文参考文献

W?rner and Oddo Critical Care 2010,14:1002 /content/14/5/1002 COMMENTARY Too cold may not be so cool: spontaneous hypothermia as a marker of poor outcome after cardiac arrest Jakobea W?rner and Mauro Oddo* See related research by den Hartog et al., /content/14/3/R121 signi ? cantly associated with long-term outcome, even Abstract when adjusted for APACHE II and SOFA scores is In a recent issue of Critical Care, den Hartog and colleagues show an association between spontaneous hypothermia, de? ned by an admission body temperature 35°C, and poor outcome in patients with coma after cardiac arrest (CA) treated with therapeutic hypothermia (TH). Given that TH alters neurological prognostication, studies aiming to identify early markers of injury severity and outcome are welcome, since they may contribute overall to optimize the management of comatose CA patients. This study provides an important message to clinicians involved in post-resuscitation care and raises important questions that need to be taken into account in future studies. indicates that low body temperature 35°C on admission after CA is a strong marker of neuro logical recovery. Previous studies have shown that spontaneous hypo- thermia is associated with increased mortality after severe trauma and haemorrhage [2]. TH has improved prognosis of hypoxic-ischemic encephalopathy [3], and might have an impact on our ability to predict ? nal patient prognosis [4]. den Hartog and colleagues identify spontaneous hypothermia as a new prognostic marker of CA. However, in accordance with Utstein’s style registry [5], arrest condi tions (that is, witnessed versus un-witnessed arrest), initial arrest rhythm (that is, ventricular ? brilla- tion versus non-ventricular ? brillation) and duration of circulatory arrest (that is, time from collapse to return of spontaneous circulation) are other well-known predictors of progno ese para meters, and particularly time