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Decreased human leukocyte antigen-D-related expression on CD14^(+)monocytes in patients with out-of-hospital cardiac arrest provided target temperature management therapy:a prospective observational study

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Emergency and Critical Care Medicine 2024年第1期4卷 16-21页

作者： Huan Shao Wei Yuan Ziren Tang Zhijiang Qi Le An Qiang Zhang Chunsheng Li Department of Emergency Medicine Beijing Chao-Yang HospitalCapital Medical UniversityBeijingChina Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation Beijing Chao-Yang HospitalCapital Medical UniversityBeijingChina.

Background:Post–cardiac arrest syndrome involves systemic inflammation,which causes subsequent neurological *** investigated the influence of targeted temperature management(TTM)therapy in patients with out-of-hospital cardiac arrest(OHCA)after return of spontaneous circulation(ROSC)by observing the changes in circulating CD14^(+)monocytes and the expression of human leukocyte antigen D–related(HLA-DR)and programmed cell death ligand 1(PD-L1)in CD14^(+)***:Adult patients admitted to the emergency department of Beijing Chao-Yang Hospital after OHCA between January 2017 and March 2018 were included in this *** control subjects,10 patients with OHCA,and 37 patients with OHCA who received 72 hours of TTM therapy were *** blood samples of patients in the OHCA and TTM groups were collected on Days 1 and 3(D1 and D3)after ROSC and evaluated for HLA-DR and PD-L1 expression on CD14^(+)monocytes using flow ***:Compared with control subjects,the percentage of circulating CD14^(+)monocytes,HLA-DR+/CD14^(+)monocyte ratios,and mean fluorescence intensity were significantly decreased in patients with *** ROSC,HLA-DR expression in CD14^(+)monocytes in the TTM group was lower than that in patients with ***,there were no significant differences in the percentage of PD-L1+/CD14^(+)monocytes or the mean fluorescence intensity between patients with OHCA and healthy ***:After ROSC,circulating CD14^(+)monocytes and HLA-DR+/CD14^(+)monocyte ratios decreased significantly in patients with *** leukocyte antigen D–related expression in CD14^(+)monocytes was lower in patients treated with TTM.

关键词： Human leukocyte antigen D-related Monocytes Out-of-hospital cardiac arrest target temperature management

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Research progress in core body temperature measurement during target temperature management

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Journal of Integrative Nursing 2022年第1期4卷 36-41页

作者： Guiying LIU Yanyan ZHANG Ling TANG Department of Neurosurgery Dongfang Hospital of Beijing University of Chinese MedicineBeijingChina Department of Nursing Dongfang Hospital of Beijing University of Chinese MedicineBeijingChina

Core body temperature(CBT)is increasingly attracting attention as crucial data during target temperature management(TTM).Accurate and continuous measurement of human CBT can effectively identify and monitor central high fever,and provide a basis for the effective implementation during TTM,which is therefore of great significance for human health care and disease *** reliable core measurement sites are nasopharynx,esophagus,bladder,rectum,pulmonary artery,etc.,but the measurement methods in these sites are all *** present,the medical field is more inclined to noninvasive data collection methods through monitoring an appropriate site(such as forehead,mouth,or axilla)depending on clinical circumstances,so as to ensure the comfort and security of patients to the greatest *** review will provide reference choosing more safe and accurate temperature measurement methods for patients during TTM by reviewing the sites and accuracy of invasive and noninvasive CBT measurements.

关键词： Core body temperature neurocritical care target temperature management

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Eff ect of post-rewarming fever after targeted temperature management in cardiac arrest patients: a systematic review and meta-analysis

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World Journal of Emergency Medicine 2023年第3期14卷 217-223页

作者： Guang-qi Guo Yan-nan Ma Shuang Xu Hong-rong Zhang Peng Sun Department of Emergency Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

BACKGROUND:targeted temperature management(TTM),as a therapeutic temperature control strategy for cardiac arrest(CA),is recommended by ***,the relationship between postrewarming fever(PRF)and the prognosis of CA patients is ***,we aim to summarize the studies regarding the infl uence of PRF on patients with ***:EMBASE,PubMed,and Cochrane Central databases were searched from inception to March 13,*** clinical trials(RCTs)and cohort studies on PRF in CA patients were *** to the heterogeneity,the meta-analysis was performed using a random eff ects model or fi xed eff ects model to calculate the pooled odds ratios(ORs)and corresponding 95%confi dence intervals(CIs).The outcome data were unfavorable neurological outcome and ***:The meta-analysis included 11 observational studies involving 3,246 *** results of the meta-analysis show that PRF(body temperature>38.0℃)has no eff ect on the neurological outcome of CA patients(OR 0.71,95%CI 0.43–1.17,I282%)and has a signifi cant relationship with lower mortality(OR 0.63;95%CI 0.49–0.80,I239%).However,PRF with a stricter defi nition(body temperature>38.5℃)was associated with worse neurological outcome(OR 1.44,95%CI 1.08–1.92,I245%)and higher mortality(OR 1.71,95%CI 1.25–2.35,I247%).CONCLUSION:This study suggests that PRF>38.0℃ may not affect the neurological outcome and have a lower mortality in CA patients who completed ***,PRF>38.5℃ is a potential prognostic factor for worse outcomes in CA patients.

关键词： Cardiac arrest target temperature management Post-rewarming fever Rebound hyperthermia

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