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Hypothermia therapy

儿科

关键词儿科 治疗方法 脑损伤治疗

词汇介绍

拓展阅读

解析

hypothermia  英/,haɪpə(ʊ)'θɜːmɪə/ 美 /,haɪpə'θɝmɪə/

释    义   n. 降低体温;低体温症

例    句   The operation was performed under deep hypothermia and extracorporeal circulation with low flow perfusion. 手术采用胸骨正中切口在体外循环深低温低流量灌注下施行。

 

therapy  英 /'θerəpɪ/  美 /'θɛrəpi/

释    义   n. 治疗,疗法

例    句   One of the not so noticed areas of rehabilitation medicine is Speech Therapy. 其中的并非如此注意到领域的康复医学是言语治疗。

概述

目前国际医学界将治疗性低温划分为轻度低温(33~35℃)、中度低温(28~32℃)、深度低温(17~ 27℃)、超深度低温(≤16℃),将轻中度低温(28~35℃) 称为亚低温。亚低温治疗机制研究显示,亚低温疗法对脑损伤的保护机制是通过多种途径实现的。亚低温治疗首先使脑细胞的需氧量减少,降低脑氧代谢率。数据显示,体温每降低1℃(在诱导低温过程中),脑细胞代谢率下降5%~7%。相关研究证实了在脑损伤的初期阶段,亚低温治疗可有效改善脑细胞损害,其作用是通过阻断脑细胞凋亡、抑制线粒体损伤作用、减轻

Metabolic resuscitation strategies to prevent organ dysfunction in sepsis复制标题

代谢复苏策略预防脓毒症器官功能障碍

发表时间:2019-06-03

影响因子:5.8

作者: Reitsema Vera A

期刊:Antioxid Redox Signal

Sepsis is the main cause of death among patients admitted to the intensive care unit (ICU). As current treatment is limited to antimicrobial therapy and supportive care, mortality remains high, which warrants efforts to find novel therapies. Mitochondrial dysfunction is emerging as a key process in the induction of organ dysfunction during sepsis and metabolic resuscitation might reveal to be a novel cornerstone in the treatment of sepsis. Here, we review novel strategies to maintain organ function in sepsis by precluding mitochondrial dysfunction by lowering energetic demand to allow preservation of ATP levels, while reducing free radical generation. As the most common strategy to suppress metabolism, i.e. cooling, does not reveal unequivocal beneficial effects and may even increase mortality, caloric restriction or modulation of energy sensing pathways (i.e. Sirtuins, AMPK) may offer safe alternatives. Similar effects may be offered when mimicking hibernation by hydrogen sulphide (H2S). In addition H2S may also confer beneficial effects through upregulation of antioxidant mechanisms, similar to the other gasotransmitters nitric oxide (NO) and carbon monoxide (CO), which display anti-oxidant and anti-inflammatory effects in sepsis. Additionally, oxidative stress may be averted by systemic or mitochondria‐targeted anti‐oxidants of which a wide range are able to lower inflammation, and reduce organ dysfunction and mortality from sepsis. Together, mitochondrial dysfunction plays a key role in the pathophysiology of sepsis. As a consequence, metabolic resuscitation might reveal to be a novel cornerstone in the treatment of sepsis.

译文

脓毒症是重症监护病房(icu)病人的主要死因。由于目前的治疗仅限于抗菌治疗和支持性治疗,死亡率仍然很高,这就需要努力寻找新的治疗方法。线粒体功能障碍是脓毒症患者器官功能障碍的一个重要诱导过程,代谢复苏可能是脓毒症治疗的新基石。在这里,我们回顾了通过降低能量需求以维持atp水平,同时减少自由基生成,从而排除线粒体功能障碍,从而维持脓毒症器官功能的新策略。由于抑制新陈代谢的最常见策略,即冷却,并不能显示明确的有益效果,甚至可能增加死亡率,热量限制或能量感应途径的调节(即sirtuins,ampk)可能提供安全的替代方案。当模拟硫化氢(H2S)冬眠时,也可能产生类似的效果。此外,硫化氢还可能通过上调抗氧化机制发挥有益作用,类似于其他气体传递素一氧化氮(no)和一氧化碳(co),后者在脓毒症中显示抗氧化和抗炎作用。此外,氧化应激可通过全身或线粒体靶向抗氧化剂来避免,其中广泛的抗氧化剂可降低炎症,降低器官功能障碍和败血症死亡率。线粒体功能障碍在脓毒症的病理生理过程中起着关键作用。因此,代谢复苏可能成为脓毒症治疗的新基石。