Evaluation of advanced cooling therapy’s esophageal cooling device for core temperature control

Abstract

Managing core temperature is critical to patient outcomes in a wide range of clinical scenarios. Previous devices designed to perform temperature management required a trade-off between invasiveness and temperature modulation efficiency. The Esophageal Cooling Device, made by Advanced Cooling Therapy (Chicago, IL), was developed to optimize warming and cooling efficiency through an easy and low risk procedure that leverages heat transfer through convection and conduction. Clinical data from cardiac arrest, fever, and critical burn patients indicate that the Esophageal Cooling Device performs very well both in terms of temperature modulation (cooling rates of approximately 1.3°C/hour, warming of up to 0.5°C/hour) and maintaining temperature stability (variation around goal temperature ± 0.3°C). Physicians have reported that device performance is comparable to the performance of intravascular temperature management techniques and superior to the performance of surface devices, while avoiding the downsides associated with both.

Oesophageal heat exchangers with a diameter of 11mm or 14.7mm are equally effective and safe for targeted temperature management

“…To quantify the thermal energy transferred by the OHE during the cooling period a mathematical model described by Naiman et al was used [21]. In brief, dt patient ( W ): energy gained by the patient; c p : specific heat of the fluid (4.186 kJ /[ kg * K ]); m : mass (water) flow rate ( L /min); △ T *: average temperature change in the patient ( T in – T out ); (△ T Ref ): average temperature change in ambient conditions.…”

Targeted temperature management using the “Esophageal Cooling Device” after cardiac arrest (the COOL study): A feasibility and safety study

“…Presently, endovascular cooling seems the most effective method regarding TH induction and TT maintenance [8,9]. The ability of the ECD to induce cooling, maintain and rewarm accurately critically ill patients has been demonstrated in previous pilot studies [11,14,15,21]. Only two series reported the use of ECD in the field of CA [14,15].…”

“…As a semi-invasive internal device, ECD could potentially improve the effectiveness of TTM and minimize the risks of invasive methods. Mathematical models and animal studies strongly support the efficacy and safety of the ECD [11][12][13]. In 2 series recently published, potential side-effects of ECD were not precisely evaluated [14,15].…”

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

“…The esophageal approach to patient temperature management offers substantial advantages to existing technologies 18 . The esophageal temperature management device maintains the functionality of the gastric tube typically placed in the critical care and surgical patient populations.…”