Comparison and evaluation of brain-functional protection with mild hypothermia technique and normal temperature technique
- VernacularTitle:亚低温技术和常温技术对脑功能保护的比较与评估
- Author:
Jun ZHANG
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2005;9(45):136-138
- CountryChina
- Language:Chinese
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Abstract:
BACKGROUND: Mild hypothermia can protect cerebral cell from injury induced by ischemia, however, whether it can protect cerebral function after cerebral resuscitation or not?OBJECTIVE: To investigate the differences between neural functional outcome and living self-care ability of patients after 3-month cerebral resuscitation with mild hypothermia technique compared with normal temperature technique.DESIGN: Randomized control study.SETTING: Emergency Center of Gulou Hospital Affiliated to Medical College of Nanjing University.PARTICIPANTS: Totally 16 patients rescued with cardiopulmonary resuscitation were selected from Gulou Hospital of Nanjing between February and October 2002. All patients had systemic lesion and intoxication, and were treated with cardiopulmonary resuscitation because of heartbeat and respiratory arrest. There were 10 males and 6 females aged 27-57 years.According to the application of mild hypothermia or not, 16 cases were divided randomly into normal temperature group and mild hypothermia group with 8 in each group.METHODS: After cardio-pulmonary resuscitation, patients in mild hypothermia group were treated with medicine + caput ice cap + electronic ice blanket method to reduce the temperature. The temperature of brain was kept at 32 to 34 ℃ for 72 hours. Patients in normal temperature group were treated at the room temperature.MAIN OUTCOME MEASURES: ① Blood-oxygen saturation, blood pH value, intracranial pressure, mean arterial pressure and Glascow Coma Scale of patients were measured on the third and seventh day after resuscitation. ② After 3-month resuscitation, Glascow Coma Scale was followed:85-100 points as functional independency, 74-84 as moderate disability,10-50 as severe disability and ＜ 10 as vegetative slate; meanwhile, living self-care ability was measured with Bathel index of 10 items in total. Every item was scored from 0 to 15 points with 100 in total, and ＜ 60 was determined as unable self-care.RESULTS: Totally 16 patients entered the final analysis. ① On the third day, mean cerebral temperature and intracranial pressure in the mild hypothermia group were lower than those in the normal temperature group [(33.1±0.26)℃, (37.4±18)℃; 15.7 mm Hg, 19.1 mm Hg, P=0.027, 0.043]. The two groups were similar in the Score of blood-oxygen saturation, blood pH value, mean arterial pressure and Glascow Coma Scale (P ＞ 0.05). ② On the seventh day, Glascow Coma Scale in the mild hypothermia group was higher than that in the normal temperature group [(9.1±1.4), (11.2±1.6) points,P=0.032]. ③ After 3 months, Glascow Coma Scale and Barthel index in the mild hypothermia group were higher than those in the normal temperature group [(12.9±1.75), (9.9±1.9) points; (86±6), (52±12) points, P ＜ 0.05-0.01].CONCLUSION: Mild hypothermia can decrease intracranial pressure during the early cerebral resuscitation, is especially effective in the recovery of long-term neural function and activity of daily living, and has remarkable protecting effect on cerebral function.
