Esophageal Cooling for Hypoxic Ischemic Encephalopathy: A Feasibility Study
Publication: Therapeutic Hypothermia and Temperature Management
Volume 11, Issue Number 3
Abstract
Targeted temperature management (TTM) is a recognized treatment to decrease mortality and improve neurological function in hypoxic ischemic encephalopathy. An esophageal cooling device (ECD) has been studied in animal models, but human data are limited. An ECD appears to offer similar benefits to intravascular cooling catheters, with potentially less risk to the patient. We studied whether the ECD could act as a substitute for intravascular cooling catheters in delivering adequate TTM after cardiac arrest. Nine patients admitted to the intensive care unit after cardiac arrest who required TTM were enrolled prospectively. The primary outcome measures were timeliness of insertion, ease of insertion, user Likert ratings, time to achieve a target temperature of 36°C, and time during which target temperature was maintained within 1°C of the 36°C goal for 24 hours by using an ECD. Time to reach target temperature was 0 to 540 minutes (mean: 113.33 minutes, median: 0 minute, standard deviation [SD]: 179.22). Maintenance of a target temperature of 36°C over 24 hours had a range of 58.33% to 100% (mean: 91.67%, median: 95.83%, SD: 13.34). Ease of insertion related to Likert ratings with a range of 1–9 (mean: 5.38, median: 5.5, SD: 3.43) and a simplicity of ECD uses a range of 4–10 (mean: 7.63, median: 8.0, SD: 1.65). Overall, there was preference for the ECD over intravascular cooling methods (mean: 6.71, mean: 6, SD: 3.01) and external cooling methods (mean: 8.0, median: 9.0, SD: 2.33). For patients requiring TTM, use of an ECD adequately allowed for TTM goals to be achieved and maintained. Overall, user evaluation was positive.
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Information & Authors
Information
Published In
Therapeutic Hypothermia and Temperature Management
Volume 11 • Issue Number 3 • September 2021
Pages: 179 - 184
PubMed: 33370218
Copyright
Copyright 2021, Mary Ann Liebert, Inc., publishers.
History
Published online: 2 September 2021
Published in print: September 2021
Published ahead of print: 23 December 2020
Topics
Authors
Authors' Contributions
P.M. designed, conducted the study and reviewed the article. T.S. participated in data gathering, study design and wrote the article. P.C. participated in study design and revised the article. P.H. helped with study design and provided support for nurses in use of the catheter. J.K. designed and conducted the study, edited the article, and provided mentorship.
Author Disclosure Statement
No competing financial interests exist.
Funding Information
No funding was received.
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