naa a22 4500 510800157 CHVBK 20180411083351.0 cr unu---uuuuu 180411e20130601xx s 000 0 eng 10.1007/s12028-012-9806-x doi (NATIONALLICENCE)springer-10.1007/s12028-012-9806-x First Clinical Experience with Intranasal Cooling for Hyperthermia in Brain-Injured Patients [Elektronische Daten] [Jacob Springborg, Karoline Springborg, Bertil Romner] Introduction: Hyperthermia is common in brain-injured patients and associated with a worse outcome. As brain rather than body temperature reduction, theoretically, is the most important in cerebral protection, there is logic in targeting cooling at the brain. Selective brain cooling can, in theory, be obtained by cooling the skull or by heat loss from the upper airways. In this preliminary safety and efficacy study, we report clinical data from brain-injured patients who because of hyperthermia were treated with intranasal cooling. Methods: Nine intubated brain-injured patients with hyperthermia were treated using a prototype intranasal balloon system perfused with cold saline. Temperature in the cerebrum, esophagus, and bladder was monitored together with intracranial pressure. Results: In only two of nine patients, normothermia was reached in the esophagus and in only four of nine patients it was reached in the bladder. When normothermia was reached, the time to normothermia was delayed. In the brain, normothermia was reached in two of five patients after approximately 72h. Median temperature curves from the first 72h of cooling showed that normothermia was not reached in any of the three compartments. The temperature in the brain and bladder were on average 0.6 and 0.5°C higher than in the esophagus. ICP increased with increasing brain temperature. We found no signs of clinical important injury to the nasal mucosa from the cold saline or pressure in the balloons. Conclusion: In brain-injured patients with hyperthermia, cooling with a prototype intranasal balloon system was clinically inadequate as the effect was delayed and not brain selective. Springer Science+Business Media New York, 2013 Brain cooling nationallicence Brain injury nationallicence Hyperthermia nationallicence Neurointensive care nationallicence Temperature nationallicence Springborg Jacob University Clinic of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark aut Springborg Karoline University Clinic of Oto-Rhino-Laryngology, Head and Neck Surgery, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark aut Romner Bertil University Clinic of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark aut Neurocritical Care Humana Press Inc 18/3(2013-06-01), 400-405 1541-6933 18:3<400 2013 18 12028 https://doi.org/10.1007/s12028-012-9806-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9806-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Springborg Jacob University Clinic of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark aut NATIONALLICENCE 700 1- Springborg Karoline University Clinic of Oto-Rhino-Laryngology, Head and Neck Surgery, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark aut NATIONALLICENCE 700 1- Romner Bertil University Clinic of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/3(2013-06-01), 400-405 1541-6933 18:3<400 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer