Neurointensivists and neurosurgeons are now using innovative therapies, including induced hypothermia, to rescue, protect and treat the brains of critically ill patients with traumatic brain injury, stroke, cardiac arrest and other severe conditions affecting the central nervous system. This therapy helps to reduce swelling and prevent secondary brain cell damage. Because of this, many patients who receive grim prognoses due to severe brain damage are experiencing once inconceivable recoveries because of induced hypothermia.
There are a variety of ways that hypothermia is induced, including intravascular cooling and water blankets. The former, an invasive procedure, involves a central venous catheter, which carries cold saline and is threaded through the femoral vein. The device serves as a heat exchange element, which helps cool the circulating blood. Non-invasive water blankets are used more often to lower core body temperature.
NYU Winthrop’s NeuroICU utilizes the latest surface therapeutic temperature technique – Arctic Sun®, which is an advanced, computer-controlled temperature management system that combines the best of the more conventional approaches. Artic Sun® couples the non-invasive benefit of water blankets with the precision and speed of intravascular catheters. The system consists of a main temperature control module connected to thin hydro-gel pads that conform to any body shape.
Patients who are eligible for induced hypothermia must be available within 12 hours of the start of the cerebral injury. To achieve maximum efficiency cooling must be initiated within six hours of the patient’s arrival in the ER. The goal is to lower the body’s temperature to 32 to 34 degrees Celsius as quickly as possible. This usually takes three to four hours, and patients are typically kept cool for a few days.
The rewarming phase is critical. Increases in temperature must be made slowly by 0.5 to 1.0 degrees Celsius per hour. Arctic Sun® provides excellent control over the process of induced hypothermia.