Retrospective Analysis of Esophageal Heat Transfer for Active Temperature Management in Post-cardiac Arrest, Refractory Fever, and Burn Patients

Abstract

Core temperature management is an important aspect of critical care; preventing unintentional hypothermia, reducing fever, and inducing therapeutic hypothermia when appropriate are each tied to positive health outcomes. The purpose of this study is to evaluate the performance of a new temperature management device that uses the esophageal environment to conduct heat transfer. De-identified patient data were aggregated from three clinical sites where an esophageal heat transfer device (EHTD) was used to provide temperature management. The device was evaluated against temperature management guidelines and best practice recommendations, including performance during induction, maintenance, and cessation of therapy. Across all active cooling protocols, the average time-to-target was 2.37 h and the average maintenance phase was 22.4 h. Patients spent 94.9% of the maintenance phase within ±1.0°C and 67.2% within ±0.5°C (574 and 407 measurements, respectively, out of 605 total). For warming protocols, all of the patient temperature readings remained above 36°C throughout the surgical procedure (average 4.66 h). The esophageal heat transfer device met performance expectations across a range of temperature management applications in intensive care and burn units. Patients met and maintained temperature goals without any reported adverse events.

Better Control of Body Temperature Is Not Associated with Improved Hemodynamic and Respiratory Parameters in Mechanically Ventilated Patients with Sepsis

“…In our study, we detected no significant changes between inTT and outTT groups in duration of mechanical ventilation, levels of PEEP and FiO 2 , noradrenaline requirement and duration and ICU survival, implying that a higher level of temperature control and lower mean temperatures during the periods of targeted temperature management are not associated with clinically relevant improvements during the course of ICU treatment. A significantly lower cumulative dose of acetaminophen in the inTT group can be explained by a greater prevalence of more invasive and effective, in our case esophageal, temperature management techniques in the inTT group [ 22 ].…”

Mechanisms of action behind the protective effects of proactive esophageal cooling during radiofrequency catheter ablation in the left atrium

“… 35 Investigations into this concept continued for the next decade, 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 but a practical device did not become available until 2014. Initial use of this device—the ensoETM (Attune Medical, Chicago, IL)—was in critical care, emergency medicine, and surgery for patient systemic temperature management 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 but adoption for use during PVI has grown rapidly, with a recent analysis of >25,000 patients finding a significant reduction in AEF rate associated with its use. 54 In September 2023, the US Food and Drug Administration (FDA) granted de novo marketing authorization for the device to reduce the likelihood of ablation-related esophageal injury resulting from RF cardiac ablation procedures.…”