低溫治療知識發展里程碑

Milestones in Therapeutic Hypothermia Knowledge Development

低溫治療適用病症包括新生兒周產期缺氧缺血性腦病變及成人突發性心跳停止經急救後恢復心跳但無意識的患者。應用調降人體的核心溫度使基礎代謝率降低，進而減少大腦對氧氣的需求量，以維持腦部能量保存及減緩細胞凋零。在醫學上認為運用低溫治療可處理突發性心跳停止、腦部嚴重損傷同時顱內壓升高、缺氧缺血性腦病變等，並降低因缺氧而發生的相關合併症及死亡率。本文參考Meleis（2017）護理理論發展的里程碑架構，彙整新生兒及成人運用低溫治療的知識發展之重要事蹟與歷史事件發展里程碑，以當時重要事件命名，共歸納分為6個時期，希望能梳理低溫治療知識的發展脈絡，提供醫護人員低溫治療照護的參考。

Therapeutic hypothermia is suitable for hypoxic ischemic encephalopathy in the neonatal period and adults who experience sudden cardiac arrest and recover from it after first aid but who are unconscious. The decrease core body temperature to reduce the Basal Metabolic Rate, thereby reducing the brain's need for oxygen to maintain brain energy conservation and relief apoptosis. Using the therapeutic hypothermia can handle sudden cardiac arrest, severe brain injury with increasing intracerebral pressure and hypoxic ischemic encephalopathy, in addition can reduce related complications and mortality due to hypoxia. The article uses the milestone structure by Meleis (2017) for development of nursing theory as reference to summarize key evidences for the development in menopausal knowledge and milestones for the relevant course of historical events, generalizing into 6 stages named based on crucial events respectively. It is expected to understand the developmental context for therapeutic hypothermia knowledge through such integration, providing medical professionals with reference for therapeutic hypothermia health care.