Giuliani E, Magnoni S, Fei M, Addis A, Zanasi R, Stocchetti N, Barbieri A
Neuron Guard S.r.l., Via L. Castelvetro 15, 41124, Modena, Italy.
Department of Anesthesiology and Intensive Care, Ospedale Fondazione IRCCS, Ca' Granda, Milan, Italy.
Neurocrit Care. 2016 Dec;25(3):464-472. doi: 10.1007/s12028-016-0257-7.
Therapeutic hypothermia (i.e., temperature management) is an effective option for improving survival and neurological outcome after cardiac arrest and is potentially useful for the care of the critically ill neurological patient. We analyzed the feasibility of a device to control the temperature of the brain by controlling the temperature of the blood flowing through the neck.
A lumped parameter dynamic model, with one-dimensional heat transfer, was used to predict cooling effects and to test experimental hypotheses. The cooling system consisted of a flexible collar and was tested on 4 adult sheep, in which brain and body temperatures were invasively monitored for the duration of the experiment.
Model-based simulations predicted a lowering of the temperature of the brain and the body following the onset of cooling, with a rate of 0.4 °C/h for the brain and 0.2 °C/h for the body. The experimental findings showed comparable cooling rates in the two body compartments, with temperature reductions of 0.6 (0.2) °C/h for the brain and 0.6 (0.2) °C/h for the body. For a 70 kg adult human subject, we predict a temperature reduction of 0.64 °C/h for the brain and 0.43 °C/h for the body.
This work demonstrates the feasibility of using a non-invasive method to induce brain hypothermia using a portable collar. This device demonstrated an optimal safety profile and represents a potentially useful method for the administration of mild hypothermia and temperature control (i.e., treatment of hyperpyrexia) in cardiac arrest and critically ill neurologic patients.
治疗性低温（即体温管理）是改善心脏骤停后生存率和神经功能转归的有效选择，对危重症神经科患者的护理可能也有用。我们分析了一种通过控制流经颈部的血液温度来控制脑部温度的设备的可行性。
采用具有一维热传递的集总参数动态模型来预测降温效果并检验实验假设。冷却系统由一个柔性项圈组成，并在4只成年绵羊身上进行了测试，在实验过程中对其脑部和体温进行了有创监测。
基于模型的模拟预测，冷却开始后脑部和身体温度会下降，脑部降温速率为0.4℃/小时，身体为0.2℃/小时。实验结果显示两个身体部位的降温速率相当，脑部温度降低0.6（0.2）℃/小时，身体温度降低0.6（0.2）℃/小时。对于一名70千克的成年人类受试者，我们预测脑部温度降低0.64℃/小时，身体温度降低0.43℃/小时。
这项工作证明了使用便携式项圈通过非侵入性方法诱导脑部低温的可行性。该设备显示出最佳的安全性，是心脏骤停和危重症神经科患者进行轻度低温治疗和体温控制（即治疗高热）的一种潜在有用方法。
