Brain Cooling in emergencies:

Since 2003, the American Heart
Association has been advising doctors
to induce hypothermia in patients who
remain unconscious after cardiac
arrest. Cooling patients for 12 to 24
hours protects their brains from the
harmful chemical reactions that come
from oxygen deprivation, and
considerably improves your chance of
surviving cardiac arrest. Yet only about
half the patients in the U.S. who could
be helped through chilling receive it.

The problem is that the current
methods of cooling people can be
cumbersome and expensive. And all
are mechanical ways of forcing the
body to cool -- from ice bags to chilled
intravenous saline -- while the body
fights to retain its normal temperature
through violent shivering that often
requires doctors to temporarily
paralyze patients.
Brain cells start dying rapidly 10 to 12
minutes after an arrest, because of the
lack of blood flow to the brain. Beyond
this time, the person cannot make a
full recovery. Even if the heart can be
restarted, the person is brain dead.




COOLING OF THE BRAIN THRU THE
NOSE
Therapeutic hypothermia, or cooling,
lowers a patient's body temperature to
help reduce the risk of injury to the
brain following a period of insufficient
blood flow due to an ischemic event,
such as a stroke or cardiac arrest.

Results from a recent study showed
that the RhinoChill  Intra-Nasal Cooling
System enabled brain temperature to
reach target several hours earlier than
patients cooled in the emergency
room. It is widely recognized that the
sooner brain temperature can be
reduced, the better the chances of
minimizing long-term damage.

In a study in this month's Circulation, a
new nasopharyngeal device was used
to initiate cooling
during cardiac arrest.
The RhinoChill Intra-Nasal Cooling
System from BeneChill (San Diego,
CA) uses a non-invasive nasal
catheter that sprays a rapidly
evaporating coolant liquid into the
nasal cavity, adjacent to the major
vascular structures of the brain. The
system is compact, battery operated
and easy and fast to insert, making it
more practical in emergency situations
than surface or intravascular cooling
devices.
Patients were randomized to either
intra-nasal cooling with RhinoChill
along with standard advanced cardiac
life support (ACLS) care or ACLS
alone until they were either
resuscitated or reached hospital, at
which stage patients in both groups
were cooled.
Results showed that the target
tympanic temperature of 34°C, used
as an approximation of brain
temperature, was reached three hours
earlier in the group receiving
pre-hospital cooling with RhinoChill.
Target core body temperature was
also reached two hours earlier. Among
patients surviving as far as hospital
admission, 47% of patients who were
cooled survived to discharge,
compared with only 31% of those who
had not been cooled. Survival rates in
the 75% of patients who received CPR
within ten minutes of collapse were
59% and 29% respectively.

The RhinoChill System received CE
Mark Approval for marketing in
European Union countries in
December 2007. It is currently planned
to commence launches in selected
European markets from October 2010.
The RhinoChill System is not for sale
in the USA.



EMERGENCY COOLING OF THE
BRAIN WITH ICE SLURRY
Pumping ice slurry into bloodstream
cools in 5 minutes by Argonne  
equipment. Data collected by the
Argonne  team have shown that the ice
slurry can cool the brain by 10.8
degrees Fahrenheit within 10 minutes.
The brain remains chilled for an hour,
which in real life would give doctors
more time to revive the heart, normal
blood flow and brain activity. This,
hopefully, would reduce or stop brain
damage.
This method is getting cool-down rates
that are 20 to 30 times faster than any
external cooling.
After the ice slurry has served its
cooling purpose, it would be suctioned
out of the endotrachea tube.


OTHER DEVELOPMENTS
Cooling hood for brain by KCI;

Cooling helmet;

Liquid perfluorocarbon