Rapid Cooling of Body and/or Brain by Irrigating with a Cooling Liquid

Abstract

Methods and devices are disclosed for providing therapeutic hypothermia using irrigation of the aerodigestive tract with cooled liquids. The disclosed method provides much more rapid therapeutic cooling to lower temperatures than could previously be achieved, thereby improving clinical outcomes. Novel cooling liquids and cooling devices are disclosed for carrying out the method. An external turbulent flow of cooling liquid may also be applied to the exterior of the head to further promote heat exchange. Multiple embodiments of devices are disclosed for performing rapid induction and maintenance of therapeutic hypothermia either in a hospital setting or in the field so that hypothermic treatment can be quickly instituted before significant tissue damage occurs. Methods are also disclosed for targeting brain cooling by irrigating the upper airway / aerodigestive tract, and more generalized cooling by irrigating the esophagus and / or stomach.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS[0001]This application is a continuation of U.S. patent application Ser. No. 12 / 842,860, filed Jul. 23, 2010, which is a continuation-in-part of PCT Patent Application No. PCT / US2009 / 031924, filed Jan. 24, 2009, which claims the benefit of U.S. Provisional Application No. 61 / 023,706, filed Jan. 25, 2008. Each of these applications is incorporated herein by reference in its entirety.FIELD OF THE INVENTION[0002]A device and method are disclosed for inducing rapid cooling of the brain and / or body in a subject.BACKGROUND OF THE INVENTION[0003]Permanent damage to the brain is a common sequelae of stroke, trauma and cardiac arrest. Each year in the United States, over 350,000 people experience an out-of-hospital cardiac arrest, and only 6.4% survive until hospital discharge without significant neurological damage. Cardiac arrest is the leading cause of death in the United States, with a direct medical cost of $2 billion per year. Stroke is the third ...

AI Technical Summary

Benefits of technology

[0011]The slow rate of cooling and delays in initial of treatment in prior therapeutic hypothermia devices and methods have been important reasons that hypothermic induction has not been more effective in preserving tissue function (such as neurological function) following hypoxia, myocardial function following myocardial infarction, or other types of function following inflammation or injury in clinical trials. These problems have been addressed herein by providing a system that permits much more rapid and / or deeper therapeutic hypothermia. In certain embodiments of the method, the cooling can be targeted to the brain (for example to preserve neurological function following a stroke, brain injury, myocardial infarction or episode of cardiac arrest) or more generally to the entire body (to control generalized inflammation or injury to non-brain structures such as the spinal cord or myocardium).

[0012]The improved system for inducing rapid hypothermia takes advantage of the inventor's recognition that the aerodigestive tract is capable of accommodating a much larger flow of cooling liquid than had previously been appreciated, and that a continuous flow of a high volume of liquid along the irregular surface of the tract provides unexpectedly rapid cooling to lower temperatures than were previously achievable in such short periods of time. In addition, the inventor recognizes the unexpected benefit of lengthening the region of the aerodigestive tract with regard to heat transfer and cooling the brain. By lengthening the regions of the aerodigestive tract that is cooled, and thereby increasing the residence time of the blood in the cooling zone, the inventor has increased the depth of cooling possible and the rate at which brain cooling can be achieved. This rapid cooling permits the method to be used more effectively in urgent situations so that effective cooling can be induced prior to completion of irreversible tissue damage. Following induction, the method is also capable of effectively maintaining cooling for sustained periods of time to provide maximal therapeutic benefit. Variations of the method can achieve targeted or selective cooling of the brain, or less selective cooling of both the brain and the body, as required by clinical conditions.

Problems solved by technology

The slow rate of cooling and delays in initial of treatment in prior therapeutic hypothermia devices and methods have been important reasons that hypothermic induction has not been more effective in preserving tissue function (such as neurological function) following hypoxia, myocardial function following myocardial infarction, or other types of function following inflammation or injury in clinical trials.

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