A new approach to selective brain cooling by a Ranque-Hilsch vortex tube.
BACKGROUND
Target temperature management is the single most effective intervention and the gold standard in post-resuscitation care today. However, cooling the whole body below 33-34 °C can cause severe complications. Therefore, developing a selective brain cooling (SBC) approach which can be initiated early to induce rapid cooling and maintain the target temperature over 12-24 h before slowly rewarming brain temperature by itself alone would be advantageous. Vortex tubes are simple mechanical devices generating cold air from a stream of compressed air without applied chemical or energy. This study investigated whether blowing cooled air from a vortex tube into the nasal cavities is safe and effective to selectively reduce and maintain before slowly rewarming brain temperature back to normal temperature.


METHODS
Experiments were conducted on ten juvenile pigs. Body temperature was measured using an esophageal and a rectal temperature probe while brain temperature with an intraparenchymal thermocouple probe. Cerebral blood flow (CBF) was measured with CT perfusion.


RESULTS
Brain temperature dropped below 34 °C within 30-40 min while a brain-esophageal temperature difference greater than 3 °C was maintained over 6 h. There was no evidence of nasal or nasopharynx mucosal swelling, necrosis, or hemorrhage on MRI examination. CBF first decreased and then stabilized together with brain temperature before increasing to the baseline level during rewarming.


CONCLUSIONS
SBC was accomplished by blowing cold air from a vortex tube into the nasal cavities. Due to its portability, the method can be used continuously in resuscitated patients in both in- and out-of-hospital situations without interruption.
Imaging Program, Lawson Health Research Institute, London, ON, Canada. mfazelba@alumni.uwo.ca.|Imaging Research Laboratories, Robarts Research Institute, 1151 Richmond Street North, London, ON, N6A 5B7, Canada. mfazelba@alumni.uwo.ca.
Mohammad
M
Fazel Bakhsheshi
Imaging Program, Lawson Health Research Institute, London, ON, Canada.|Imaging Research Laboratories, Robarts Research Institute, 1151 Richmond Street North, London, ON, N6A 5B7, Canada.
Yong
Y
Wang
Imaging Program, Lawson Health Research Institute, London, ON, Canada.|Imaging Research Laboratories, Robarts Research Institute, 1151 Richmond Street North, London, ON, N6A 5B7, Canada.
Lynn
L
Keenliside
Imaging Program, Lawson Health Research Institute, London, ON, Canada.|Imaging Research Laboratories, Robarts Research Institute, 1151 Richmond Street North, London, ON, N6A 5B7, Canada.|Department of Medical Imaging and Biophysics, The University of Western Ontario, London, ON, Canada.
Ting-Yim
TY
Lee
Brain temperature; Cerebral blood flow; Intranasal cooling; Physiologic monitoring; Selective brain cooling; Vortex tube
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