Novel intracranial brain cooling catheter to mitigate brain injuries
- Remo M Moomiaie1,
- Graham Gould2,
- Daniel Solomon1,
- John Simmons3,
- Jung Kim4,
- Donald Botta1,
- John A Elefteriades1
- 1Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
- 2Section of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA
- 3Coolspine LLC, Woodbury, CT, USA
- 4Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA
- Correspondence to Dr J A Elefteriades, Section of Cardiac Surgery, Yale University School of Medicine, Boardman 2, 333 Cedar Street, New Haven, CT 06510, USA; john.elefteriades{at}yale.edu
-
Contributors All authors contributed substantially. RMM conducted the experiments and wrote the first draft of the paper. GG conducted the experiments and brought neurosurgical expertise. Dr Solomon assisted in the experiments. JS assisted in the experiments and in the development and implementation of the device. DB participated in the experiments. JAE developed the device, conceived the experiment, participated in portions of the experiments and participated significantly in the writing of the manuscript.
- Received 28 November 2010
- Revised 24 February 2011
- Accepted 4 April 2011
- Published Online First 14 June 2011
Abstract
Background The neuroprotective effects of cooling the spinal cord in a sheep model by a self-contained intrathecal catheter was reported recently by the authors. The present study was designed to determine if cooling catheters in the lateral ventricles of the brain can effectively cool the CSF and thereby reduce brain temperature while maintaining systemic normothermia.
Methods The cooling catheter is a self-contained system that circulates a cold fluid and cools the CSF that circulates in the brain. The CSF in turn cools the surrounding brain by conduction. Burr holes were made in the skull and the catheter was placed into the lateral ventricles using the standard method for placement of ventriculostomy catheters. To monitor the cooling effect, four temperature probes were placed in the brain (left and right hemispheres of the brain in anterior and posterior locations to the ventricles).
Results Five experiments were successfully completed. The mean brain temperature for all sheep decreased to 34.5°C (mean) during the 3 h cooling period (9.7% reduction from baseline brain temperature of 38.2°C). Cooling fluid was circulated through the catheter at a rate of 50 ml/min. The lowest achieved brain temperature during cooling was 26.7°C. When cooling was stopped, the brain temperature readings equilibrated with the core temperature promptly. Post mortem examination of the brains showed no morphologic changes under gross or histologic examinations.
Conclusion Localized cooling of the brain to moderate hypothermic levels while maintaining relative systemic normothermia was demonstrated in an animal model with intraventricular cooling catheters.
Footnotes
-
Funding This research has been supported by Phase I and Phase II STTR grants from the National Science Foundation.
-
Competing interests JS and JAE are principals of Coolspine Inc, a very small Yale University start-up company developed to advance these topical cooling technologies. There are no commercial products and no near-term plans for such.
-
Ethics approval All experiments were approved and monitored by the Institutional Animal Care and Use Committee.
-
Provenance and peer review Not commissioned; externally peer reviewed.
