Early targeted brain COOLing in the cardiac CATHeterisation laboratory following cardiac arrest (COOLCATH)

Abstract

In this study, Rhinochill was not found to be more efficient than Blanketrol for TH induction, although there was a non-significant trend in favour of Rhinochill that potentially warrants further investigation with a larger trial.

Selective Brain Hypothermia in Acute Ischemic Stroke: Reperfusion Without Reperfusion Injury

“…Selective brain hypothermia is an attractive alternative to systemic hypothermia, providing focused cooling of the injured organ and avoiding the complications of systemic hypothermia, including intubation, shivering, pneumonia, altered coagulability, and cold-induced stress reactions (58). A variety of devices and strategies have been developed to induce selective brain hypothermia and tested in preclinical models and early human clinical trials, including intranasal selective hypothermia, transvenous endovascular cooling, extraluminal vascular cooling, and epidural cerebral cooling (63)(64)(65)(66)(67)(68)(69)(70)(71)(72). However, advance of these devices in clinical development has been constrained by slow onset of cooling induced by external cerebral cooling techniques and procedural time delay needed to place internal nasopharyngeal cooling devices.…”

Insight into the use of tympanic temperature during target temperature management in emergency and critical care: a scoping review

“… The cooling time to reach the bladder TT was longer, 180 (70; 240) min (p = NR). Islam et al [ 49 ] OHCA Intervention: N: 37 Age: 64 ± 12 y Male: 86% Control: N: 37 Age: 62 ± 13 y Male: 74% Intervention: post-ROSC intra-nasal cooling. TT: 34 °C (tympanic and esophageal).…”

“…In one study, the procedure was started in the pre-hospital setting [ 60 ]. In all the studies, target temperature was in the range of mild hypothermia (33–34 °C), whereas the TTM cooling procedures and protocols varied among the studies, including (i) local cooling procedures [ 44 – 46 , 48 , 49 , 58 ], (ii) whole body cooling [ 47 , 57 , 59 , 60 ], and (iii) a combination of the two [ 50 – 56 ]. Comparative core-temperature measurements, including esophageal, rectal, bladder, iliac, or pulmonary artery sites, were mostly available for the studies performed in hospital settings [ 44 , 45 , 47 – 51 , 53 – 55 ], and provided indications of T Ty accuracy in relation to the TTM phases [ 50 , 51 ].…”

“…During local cooling procedures, such as trans-nasal cooling, the tympanic site generally displayed a faster response than the rectal and bladder ones [ 44 , 46 ]. The tympanic site showed comparable cooling times with respect to the esophageal site [ 49 ], although it showed larger temperature variations in response to the cooling maneuvers [ 44 , 49 ]. T Ty showed larger bias compared to esophageal temperature during head and especially head-neck cooling, where it underestimated esophageal T with an average bias of −1.65 °C and −3.06 °C (p=0.001), respectively [ 54 ].…”

RhinoChill ® –more than an “ice-cream headache (1)” serious adverse event related to transnasal evaporative cooling

“…With great interest we recognized the recent study by Islam et al 2 comparing the efficiency of transnasal versus surface cooling for inducing therapeutic hypothermia in patients with cardiac arrest. For transnasal cooling with the RhinoChill ® -system perfluorocarbon is sprayed through a set of tubes placed into the nasopharynx driven by high pressure air or oxygen.…”