低溫治療於心跳停止復甦後病人之應用與照護

Hypothermia Therapy and Nursing Care for Cardiac Arrest Patients after Resuscitation

吳承學(Cheng-Hsueh Wu) ； 劉慧玲(Huey-Ling Liou)

《榮總護理》 28卷4期 (2011/12) Pp. 334-340

https://doi.org/10.6142/VGHN.28.4.334

摘要

突然心跳停止經急救後而存活者因腦部缺血損傷可能導致較差的神經功能及死亡。心肺復甦後能自動回復血液循環所產生的損傷被稱之為再灌流的缺血性損傷。再灌流的缺血性損傷與生化反應有關，此生化反應可以藉由誘導低溫而被終止。臨床處置準則目前也證實低溫（32-34℃）對心跳停止復甦後的治療是可以改善神經功能的預後。相關的研究也顯示低溫治療是安全的、少有合併症及可以增加病人的存活率，因此美國心臟學會建議低溫治療使用於突發性心跳停止經急救後回復自發性心跳的病人。於本文就低溫治療的生理、作用機轉、臨床實證研究、低溫治療的方法、合併症和治療分期之照護做介紹。

關鍵字

低溫治療 ； 心跳停止

並列摘要

Sudden cardiac arrest survivors suffer from ischaemic brain injury that may lead to poor neurological outcome and death. The injury during cardiopulmonary resuscitation (CPR) and successfully restored spontaneous circulation (ROSC) is described as a global ischaemia-reperfusion injury. The reperfusion injury that occurs is associated with damaging biochemical reactions, which are suppressed by lowering body temperature (induced hypothermia). Guidelines now endorse induced hypothermia (32-34℃) as a post-resuscitation treatment to improve neurological outcomes following cardiac arrest. Relevant studies have proved hypothermia (32-34℃) to be safe, with few complications and improved survival rate, as recommended by the American Heart Association. In this article, physiology and mechanism of hypothermia, evidence-based researches, intervention and complication of hypothermia, and care of hypothermia in different periods are described.

並列關鍵字

Hypothermia ； cardiac arrest