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ID 53856
フルテキストURL
著者
Takeda, Yoshimasa Department of Anesthesiology, Okayama University Medical School
Kawashima, Takahisa Department of Emergency and Critical Care Medicine, Iseikai Hospital
Kiyota, Kazuya Tertiary Emergency Medical Center, Saitama Red-Cross Hospital
Oda, Shigeto Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine
Morimoto, Naoki Emergency and Critical Care Center, Tsuyama Central Hospital
Kobata, Hitoshi Osaka Mishima Emergency Critical Care Center
Isobe, Hisashi Department of Emergency Diagnosis and Treatment, Himeji Medical Center
Honda, Mitsuru Emergency and Critical Care Center, Toho University Faculty of Medicine
Fujimi, Satoshi Critical Care and Trauma Center, Osaka General Medical Center
Onda, Jun Department of Neurosurgery, Kitakyushu Yugawa Hospital
I, Seishi Department of Emergency Medicine, Japanese Red Cross Kumamoto Hospital
Sakamoto, Tetsuya Trauma and Resuscitation Center, Teikyo University School of Medicine
Ishikawa, Masami Emergency Department, Kure Kyosai Hospital
Nakano, Hiroshi Emergency Department, Okazaki City Hospital
Sadamitsu, Daikai Emergency and Critical Care Center, Osaka Medical Center
Kishikawa, Masanobu Emergency and Critical Care Center, Saiseikai Fukuoka General Hospital
Kinoshita, Kosaku Emergency and Critical Care Center, Nihon University Itabashi Hospital
Yokoyama, Tomoharu Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center
Harada, Masahiro Emergency and Critical Care Center, Kumamoto Medical Center
Kitaura, Michio Department of Emergency and Critical Care Medicine, Kagawa Rosai Hospital
Ichihara, Kiyoshi Department of Clinical Laboratory Science, Yamaguchi University Graduate School of Medicine
Hashimoto, Hiroshi Daiken Medical Co.
Tsuji, Hidekazu Daiken Medical Co.
Yorifuji, Takashi Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science
Nagano, Osamu Department of Disaster and Emergency Medicine, Kochi University Medical School
Katayama, Hiroshi Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School
Ujike, Yoshihito Department of Emergency and Critical Care Medicine, Okayama University Medical School
Morita, Kiyoshi Department of Anesthesiology, Okayama University Medical School
抄録
AIM: Cooling the pharynx and upper oesophagus would be more advantageous for rapid induction of therapeutic hypothermia since the carotid arteries run in their vicinity. The aim of this study was to determine the effects of pharyngeal cooling on brain temperature and the safety and feasibility for patients under resuscitation. METHODS: Witnessed non-traumatic cardiac arrest patients (n=108) were randomized to receive standard care with (n=53) or without pharyngeal cooling (n=55). In the emergency room, pharyngeal cooling was initiated before or shortly after return of spontaneous circulation by perfusing physiological saline (5 °C) into a pharyngeal cuff for 120 min. RESULTS: There was a significant decrease in tympanic temperature at 40 min after arrival (P=0.02) with a maximum difference between the groups at 120 min (32.9 ± 1.2°C, pharyngeal cooling group vs. 34.1 ± 1.3°C, control group; P<0.001). The return of spontaneous circulation (70% vs. 65%, P=0.63) and rearrest (38% vs. 47%, P=0.45) rates were not significantly different based on the initiation of pharyngeal cooling. No post-treatment mechanical or cold-related injury was observed on the pharyngeal epithelium by macroscopic observation. The thrombocytopaenia incidence was lower in the pharyngeal cooling group (P=0.001) during the 3-day period after arrival. The cumulative survival rate at 1 month was not significantly different between the two groups. CONCLUSIONS: Initiation of pharyngeal cooling before or immediately after the return of spontaneous circulation is safe and feasible. Pharyngeal cooling can rapidly decrease tympanic temperature without adverse effects on circulation or the pharyngeal epithelium.
キーワード
Brain ischaemia
Cardiac arrest
Intra-arrest cooling
Pharynx
Selective cooling
Therapeutic hypothermia
備考
This is an open access article under the CC BY-NC-ND license
発行日
2014-12
出版物タイトル
Resuscitation
85巻
12号
出版者
Elsevier Ireland Ltd.
開始ページ
1647
終了ページ
1653
ISSN
0300-9572
NCID
AA00817253
資料タイプ
学術雑誌論文
オフィシャル URL
http://dx.doi.org/10.1016/j.resuscitation.2014.09.014
関連URL
http://ousar.lib.okayama-u.ac.jp/metadata/53855
言語
English
著作権者
Copyright © 2014 The Authors
論文のバージョン
publisher
査読
有り
DOI
PubMed ID
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