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  • Brain temperature changes during selective cooling with endovascular intracarotid cold saline infusion: simulation using human data fitted with an integrated mathematical model

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Basic science
Original research
Brain temperature changes during selective cooling with endovascular intracarotid cold saline infusion: simulation using human data fitted with an integrated mathematical model
  1. Matthew Aaron Harold Neimark1,
  2. Angelos Aristeidis Konstas2,
  3. Leslie Lee3,
  4. Andrew Francis Laine4,
  5. John Pile-Spellman5,
  6. Jae Choi6
  1. 1Department of Radiology, SUNY Downstate, Brooklyn, New York, USA
  2. 2Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
  4. 4Department of Biomedical Engineering, Columbia University, New York, USA
  5. 5Department of Interventional Radiology, Neurological Surgery PC, Great Neck, New York, USA
  6. 6Department of Neurology, Columbia University, New York, USA
  1. Correspondence to Dr M A H Neimark, Department of Radiology, SUNY Downstate, 451 Clarkson Avenue Box #47, B Bldg, 3rd floor, Room 3304, Brooklyn, New York, USA; man2003{at}columbia.edu

Abstract

The feasibility of rapid cerebral hypothermia induction in humans with intracarotid cold saline infusion (ICSI) was investigated using a hybrid approach of jugular venous bulb temperature (JVBT) sampling and mathematical modeling of transient and steady state brain temperature distribution. This study utilized both forward mathematical modeling, in which brain temperatures were predicted based on input saline temperatures, and inverse modeling, where brain temperatures were inferred based on JVBT. Changes in ipsilateral anterior circulation territory temperature (IACT) were estimated in eight patients as a result of 10 min of a cold saline infusion of 33 ml/min. During ICSI, the measured JVBT dropped by 0.76±0.18°C while the modeled JVBT decreased by 0.86±0.18°C. The modeled IACT decreased by 2.1±0.23°C. In the inverse model, IACT decreased by 1.9±0.23°C. The results of this study suggest that mild cerebral hypothermia can be induced rapidly and safely with ICSI in the neuroangiographical setting. The JVBT corrected mathematical model can be used as a non-invasive estimate of transient and steady state cerebral temperature changes.

https://doi.org/10.1136/neurintsurg-2011-010150

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    Footnotes

    • Funding This study was supported by a grant from the Dana Foundation (Clinical Neuroscience Research Award; JP-S and JC).

    • Competing interests None.

    • Ethics approval The study was approved by the institutional review board of Columbia University Medical Center.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement For access to the raw data from this study, including jugular venous and bladder temperature sets for individual subjects, please contact the corresponding author (man2003{at}columbia.edu).