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Regulierte Hypothermie nach Herz-Kreislauf-Stillstand

Ein Blick in die Zukunft

Regulated hypothermia after cardiac arrest

A glimpse into the future

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Zusammenfassung

Die Einführung der therapeutischen milden Hypothermie nach Herz-Kreislauf-Stillstand eröffnete erstmals die Möglichkeit, den neuronalen Schaden nach globaler zerebraler Ischämie günstig zu beeinflussen. Gegenwärtig erfolgt die Induktion der Hypothermie durch externe oder interne Kühlung des Patienten (forcierte Hypothermie). Hierdurch werden jedoch physiologische Gegenregulationsmechanismen aktiviert, die möglicherweise ihrerseits ein Risiko für den Patienten darstellen. Ziel dieses Übersichtsartikels ist es, einen Ausblick auf mögliche, zurzeit noch experimentelle Ansätze zu geben, durch die sich stattdessen pharmakologisch der Sollwert der Körpertemperatur nach unten verstellen lässt (regulierte Hypothermie). Es werden verschiedene Substanzklassen bezüglich ihrer Wirkung auf die Thermoregulation und ihrer Anwendung in Tiermodellen der zerebralen Ischämie diskutiert.

Abstract

The introduction of therapeutic mild hypothermia after cardiac arrest allows the neuronal damage caused by global cerebral ischemia to be advantageously influenced for the first time. Currently, hypothermia is induced by external or internal cooling of the patient (forced hypothermia). However, this results in activation of counter-regulation mechanisms which could be possible risk factors for the patient. The aim of this article is to give a review of possible, but at present only experimental, methods which could allow the body temperature set point to be decreased pharmacologically (regulated hypothermia). Various classes of substances will be discussed based on their effect on thermoregulation and their performance in animal experiments on cerebral ischemia.

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  1. Klinik für Anaesthesiologie, Universitätsklinikum, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    A. Schneider,  E. Popp & B. W. Böttiger

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Schneider, A., Popp, E. & Böttiger, B.W. Regulierte Hypothermie nach Herz-Kreislauf-Stillstand. Anaesthesist 55, 1247–1254 (2006). https://doi.org/10.1007/s00101-006-1080-x

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