Abstract
Effective control of core body temperature and producing hypothermia is the standard of care for comatose patients with cardiac arrest and also in neurogenic fevers. Nasopharyngeal space has been a region of great interest to induce therapeutic hypothermia for a long time. This is primarily due to the favorable location of the nasal heat exchanger directly beneath the brain, the main target for hypothermia. This chapter focuses on achieving therapeutic hypothermia of the brain and core body temperature by using transnasal dry air.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Geurkink N. Nasal anatomy, physiology, and function. J Allergy Clin Immunol. 1983;72(2):123–8.
Covaciu L, Allers M, Enblad P, et al. Intranasal selective brain cooling in pigs. Resuscitation. 2008;76:83–8.
Andrews PJD, Harris B, Murray GD. A randomised cross-over trial of the effects of airflow through the upper respiratory tract of intubated, brain injured patients on brain temperature and selective brain cooling. Br J Anaesth. 2005;94:330–5.
Buscha H, Eichwedeb F, Födisch M, Taccone FS, et al. Safety and feasibility of nasopharyngeal evaporative cooling in the emergency department setting in survivors of cardiac arrest. Resuscitation. 2010;81:943–9.
Castren M, Nordberg P, Svensson L, et al. Intra-arrest transnasal evaporative cooling a randomized, prehospital, multicenter study (PRINCE: pre-ROSC intranasal cooling effectiveness). Circulation. 2010;122:729–36.
Bollera M, Lampea JW, Katza JM, Barbutc D, Beckera LB. Feasibility of intra-arrest hypothermia induction: a novel nasopharyngeal approach achieves preferential brain cooling. Resuscitation. 2010;81:1025–30.
Guan J, Barbut D, Wang H, Li Y, Tsai M, Sun S, Inderbitzen B, Weil MH, Tang W. Rapid induction of head cooling by the intranasal route during cardiopulmonary resuscitation improves survival and neurological outcomes. Crit Care Med. 2008;36(suppl):S428–33.
Abou-Chebl A, Sung G, Barbut D, Torbey M. Local brain temperature reduction through intranasal cooling with the RhinoChill device: preliminary safety data in brain-injured patients. Stroke. 2011;42(8):2164–9.
Edwards C, Lowe KC, Röhlke W, Geister U, Reuter P, Meinert H. Effects of a novel perfluorocarbon emulsion on neutrophil chemiluminescence in human whole blood in vitro. Artif Cells Blood Substit Immobil Biotechnol. 1997;25:255–60.
Flaim S. Pharmacokinetics and side effects of perfluorocarbon-based blood substitutes. Artif Cells Blood Substit Immobil Biotechnol. 1994;22:1043–54.
Bucala R, Kawakami M, Cerami A. Cytotoxicity of a perfluorocarbon blood substitute to macrophages in vitro. Science. 1983;27:965–7.
OECD/UNEP Global PFC Group. Synthesis paper on per- and polyfluorinated chemicals (PFCs). Paris: Environment, Health and Safety, Environment Directorate, OECD; 2013.
Harris S, Bansbach J, Dietrich I, Kalbhenn J, Schmutz A. RhinoChill(®)-more than an “ice-cream headache (1)” serious adverse event related to transnasal evaporative cooling. Resuscitation. 2016;103:e5–6.
Einer-Jensen N, Khorooshi MH. Cooling of the brain through oxygen flushing of the nasal cavities in intubated rats: an alternative model for treatment of brain injury. Exp Brain Res. 2000;130:244–7.
Chava R, Zviman M, Raghavan MS, Halperin H, et al. Rapid induction of therapeutic hypothermia using transnasal high flow dry air. Ther Hypothermia Temp Manag. 2017;7(1):50–6.
Acknowledgements
This work was supported by a NIH SBIR grant to Harikrishna Tandri (1 R44 HL108542-01A1).
Disclosures
Dr. Tandri holds patents for transnasal cooling and invented the transnasal dry air cooling device (CoolStat).
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Chava, R., Tandri, H. (2019). Transnasal Induction of Therapeutic Hypothermia for Neuroprotection. In: Chen, J., Wang, J., Wei, L., Zhang, J. (eds) Therapeutic Intranasal Delivery for Stroke and Neurological Disorders. Springer Series in Translational Stroke Research. Springer, Cham. https://doi.org/10.1007/978-3-030-16715-8_1
Download citation
DOI: https://doi.org/10.1007/978-3-030-16715-8_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-16713-4
Online ISBN: 978-3-030-16715-8
eBook Packages: MedicineMedicine (R0)