Doctors often cool down people who have had a cardiac arrest or stroke to reduce brain damage, usually with water-filled blankets. But doing this with a device that circulates cold water through a tube down the throat to the stomach may have some advantages.
In a pilot study testing the device in people who had a cardiac arrest, doctors felt it was more convenient than blankets and patients reached the target temperature within about two hours.
While the study didn’t directly compare the new approach with blankets, two hours is relatively fast, says Marvin Wayne at St Joseph Medical Center in Bellingham, Washington state.
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It has been known for some time that cooling people down a few degrees can help after cardiac arrest or stroke. It was thought that cooling to 32°C was necessary, then in 2013 a trial showed it was just as beneficial to keep people at 36°C. Although this is only about 1 degree below normal body temperature, people who have had brain injuries sometimes have a fever, so the cooling avoids this overheating.
You have to cool to achieve normal body temperature, says John Andrzejowski at Sheffield Teaching Hospitals in the UK, who wasn’t involved in the study.
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The internal cooling device, made by US firm Attune Medical, was used on 52 people in the new study, aiming for 32°C or 36°C depending on their doctor’s preference. In 30 people the target temperature was reached using the device alone; in the rest, their doctors felt they needed to add blankets as they weren’t cooling fast enough.
But if the new approach helps doctors avoid blankets at least sometimes, that is an advantage, says Wayne. “Blankets get in the way and cover people up – a patient becomes somewhat invisible.”
Andrzejowski says a larger randomised trial is needed to check the device doesn’t damage the lining of the oesophagus on its way down to the stomach. “If it does work and it’s not too expensive it sounds promising.”
Reference: medRxiv,
