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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
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Neurocritical care management to improve neurologic outcome for postcardiac arrest syndrome (PCAS) has focused considerably on targeted temperature management (TTM). TTM attenuates the destructive processes following ischemia/reperfusion in PCAS. The principal indication of TTM is a patient with sustained coma after return of spontaneous circulation (ROSC). TTM can be strongly recommended with a target temperature between 32°C and 36°C for patients with shockable rhythm and out-of-hospital cardiac arrest (OHCA) and weakly recommended for patients with initial asystole or pulseless electrical activity with OHCA and those with in-hospital cardiac arrest. TTM is induced and maintained using a cooling device with body temperature feedback under appropriate analgosedation. It requires the intensive management of various systemic respiratory, circulatory, and metabolic parameters that control shivering to prevent secondary brain damage. Considering the cerebral perfusion pressure, it is suggested that the mean arterial pressure should be particularly maintained over 80 mm Hg. Seizure management, including continuous electroencephalography monitoring, is also needed. Finally, we must continue the above mentioned care during and after the rewarming phase, because high fever and shivering may appear again during this period. Furthermore, neurological prognostication should be performed at least 72 hours after ROSC through clinical investigations and multimodal testing without sedation.
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참고문헌 (153)
참고문헌 신청
Polderman KH / 2009 / Mechanisms of action, physiological effects, and complications of hypothermia / Crit Care Med 37(7 Suppl):S186~S202
Sekhon MS / 2017 / Clinical pathophysiology of hypoxic ischemic brain injury after cardiac arrest : a"two-hit"model / Crit Care 21:90
Bro-Jeppesen J / 2013 / Post-hypothermia fever is associated with increased mortality after out-of-hospital cardiac arrest / Resuscitation 84:1734~1740
Zeiner A / 2001 / Hyperthermia after cardiac arrest is associated with an unfavorable neurologic outcome / Arch Intern Med 161:2007~2012
Hypothermia after Cardiac Arrest Study Group / 2002 / Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest / N Engl J Med 346:549~556
Sekhon MS / 2017 / Clinical pathophysiology of hypoxic ischemic brain injury after cardiac arrest : a"two-hit"model / Crit Care 21:90
Bro-Jeppesen J / 2013 / Post-hypothermia fever is associated with increased mortality after out-of-hospital cardiac arrest / Resuscitation 84:1734~1740
Zeiner A / 2001 / Hyperthermia after cardiac arrest is associated with an unfavorable neurologic outcome / Arch Intern Med 161:2007~2012
Hypothermia after Cardiac Arrest Study Group / 2002 / Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest / N Engl J Med 346:549~556
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