Therapeutische milde Hypothermie nach Herz-Kreislauf-Stillstand

ZusammenfassungDie Anwendung einer therapeutischen Hypothermie nach verschiedenen Arten von hypoxisch-ischämischen Ereignissen zählt seit langer Zeit zu den Konzepten einer unspezifischen Zellprotektion. Nachdem Versuche mit tiefen Hypothermieformen nach Herz-Kreislauf-Stillstand im letzten Jahrhundert keine positiven Ergebnisse erbrachten, sind jetzt aktuelle Daten zum Einsatz der milden Hypothermie verfügbar, die den klinischen Nutzen eindeutig belegen. Sowohl Daten der europäischen Multicenteruntersuchung als auch jene aus Australien zeigen einen deutlichen Überlebensvorteil für Patienten, die für 12 bzw. 24 h auf 32–34°C gekühlt wurden. Dies führte 2003 zu der Aufnahme der milden Hypothermie (32–34°C) als klare Empfehlung in die International Liaison Committee on Resuscitation- (ILCOR-)Guidelines zur Behandlung von bewusstlosen Patienten nach prähospitalem Herz-Kreislauf-Stillstand. Dieser Artikel gibt eine Übersicht über bestehende Konzepte und zukünftige Perspektiven der therapeutischen milden Hypothermie.AbstractThe use of therapeutic hypothermia following different hypoxic-ischaemic insults has played an important role in various concepts of non-specific protection of cells for a long time. Although the use of deep therapeutic hypothermia after cardiac arrest in the last century did not lead to an improved outcome, recent data have demonstrated very positive effects of mild therapeutic hypothermia. The data from the European multicenter trial as well as those from Australia have clearly demonstrated a decrease in mortality and a better neurological outcome for patients being cooled to 32–34°C for 12 or 24 h. In 2003, this led to the implementation of mild therapeutic hypothermia (32–34°C) into the International Liaison Committee on Resuscitation (ILCOR) recommendations and guidelines for the treatment of unconscious patients after prehospital cardiac arrest. This article gives an overview on existing concepts and future perspectives of therapeutic mild hypothermia.

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