Endovascular cooling for moderate hypothermia in patients with acute stroke: first results of a novel approach.
OBJECTIVE
We undertook this study to evaluate the feasibility of inducing and maintaining moderate hypothermia with the use of endovascular rather than surface cooling.


METHODS
Six patients with severe acute ischemic stroke were treated with moderate hypothermia. This was induced and maintained by circulating temperature-adjusted normal saline in a closed-loop system entailing 3 balloons located near the tip of a central line, which dwelled in the inferior vena cava.


RESULTS
The mean+/-SD initial temperature of the patients was 37+/-1 degrees C (range, 35.5 degrees C to 38.4 degrees C). The pace of cooling was 1.4+/-0.6 degrees C/h, and target temperature was reached after 3+/-1 hours (range, 2 to 4.5 hours). During hypothermia, the maximal temperature observed was 33.4 degrees C, and the minimal temperature was 32.2 degrees C. Temperature deviations >0.2 degrees C or >0.3 degrees C were observed during 21% or 10% of the hours under hypothermia, respectively. Singultus was the only device-related complication encountered. Pulmonary infection, arterial hypotension, bradycardia, arrhythmia, and thrombocytopenia were the most common side effects.


CONCLUSIONS
Induction and maintenance of hypothermia with an intravenous cooling device are feasible. The safety of this approach remains to be evaluated.
Georgiadis
D
D
Department of Neurology, University of Heidelberg, Germany.
Schwarz
S
S
Kollmar
R
R
Schwab
S
S
D000208:Acute Disease; D002406:Catheterization, Peripheral; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020521:Stroke / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D014682:Vena Cava, Inferior