Epidural cooling for selective brain hypothermia in porcine model

Abstract

The data demonstrate that epidural space cooling was technically feasible and useful for selective brain hypothermia, and the target temperatures are easily controlled. The induction of hypothermia was rapid and maintained for a long period of time, whereas the body temperature was maintained within the normal range and without hemodynamic instability.

Protective effect against focal cerebral ischemia injury in acute phase of a novel invasive device for regional hypothermia

“…Accordingly, craniectomy with a larger area covering the ischemic region might be an option not only for decompression but also for a certain extent of regional hypothermia at the superficial cortex. 39 Furthermore, the documented temperature differences (26 C: À1.7 C and À0.7 C; 20 C: À3.5 C and À1.3 C; 14 C: À5.4 C and À1.9 C; 10 C: À6.3 C and À2.2 C at 3.16 mm and 6.40 mm distances, respectively) in the superficial cortex in our study suggested a lower cooling efficiency compared to direct liquid perfusion (20 C: À3ÀÀ4 C; 14 C: À9 C) 19,21 and cooling coil placed between the temporal muscle and skull (31 C: À5 C; 26 C: À10 C). 38 Our result clearly showed that the cooling effect was confined within a relatively small area, implying that multiple devices might be required in clinical applications.…”

“…For evaluating the cooling efficiency, the static brain temperature in our study was 32e33 C, lower than the 36 C of previous reports. 19,21,38 This could be due to the difference in surgical approach, as craniectomy was performed in our experimental setting for the placement of temperature probes and consequently promoted temperature radiation from the open skull. Accordingly, craniectomy with a larger area covering the ischemic region might be an option not only for decompression but also for a certain extent of regional hypothermia at the superficial cortex.…”

Brain hypothermia induced by cold spinal fluid using a torso cooling pad: theoretical analyses

“…Several methods for inducing selective hypothermia within brain tissue have been proposed and implemented, which include epidural cooling, cooling helmet, nasopharyngeal cooling, forced convection using a fan, and cooling the blood supplied to the brain [1,3,6,10,18,19,22,34]. These experimental studies show positive neuroprotection of hypothermia in preventing permanent damage by decreasing the brain temperature by up to 7°C within an hour.…”

“…These experimental studies show positive neuroprotection of hypothermia in preventing permanent damage by decreasing the brain temperature by up to 7°C within an hour. However, the methods that result in the biggest temperature reductions within a short duration are the more invasive methods that may involve surgical intervention and patient discomfort, such as epidural cooling, direct cooling of the brain blood supply, and nasopharyngeal cooling [1,3,10,35]. In this study, the temperature of the brain during a proposed non-invasive spinal cord hypothermia treatment session is simulated.…”

Selective therapeutic hypothermia: A review of invasive and noninvasive techniques

“…Epidural cooling -Cheng et al 41 used continuous epidural irrigation with chilled saline administered via burr holes to convectively cool the brain. In their porcine model, they achieved epidural temperatures of 13°C, subdural temperatures of 19°C and parenchymal temperatures of 28°C.…”