Induction, maintenance, and reversal of therapeutic hypothermia with an esophageal heat transfer device

Erik Kulstad, Anja K. Metzger, D. Mark Courtney, Jennifer Rees, Patrick Shanley, Timothy Matsuura, Scott McKnite, Keith Lurie

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Aim of the study: To evaluate a novel esophageal heat transfer device for use in inducing, maintaining, and reversing hypothermia. We hypothesized that this device could successfully induce, maintain (within a 1. °C range of goal temperature), and reverse, mild therapeutic hypothermia in a large animal model over a 30-h treatment protocol. Methods: Five female Yorkshire swine, weighing a mean of 65. kg (range 61-70). kg each, were anesthetized with inhalational isoflurane via endotracheal intubation and instrumented. The esophageal device was connected to an external chiller and then placed into the esophagus and connected to wall suction. Reduction to goal temperature was achieved by setting the chiller to cooling mode, and a 24. h cooling protocol was completed before rewarming and recovering the animals. Histopathologic analysis was scheduled for 3-14 days after protocol completion. Results: Average baseline temperature for the 5 animals was 38.6. °C (range 38.1-39.2. °C). All swine were cooled successfully, with average rate of temperature decrease of 1.3. °C/h (range 1.1-1.9). °C/h. Standard deviation from goal temperature averaged 0.2. °C throughout the steady-state maintenance phase, and no treatment for shivering was necessary during the protocol. Histopathology of esophageal tissue showed no adverse effects from the device. Conclusion: A new esophageal heat transfer device successfully and safely induced, maintained, and reversed therapeutic hypothermia in large swine. Goal temperature was maintained within a narrow range, and thermogenic shivering did not occur. These findings suggest a useful new modality to induce therapeutic hypothermia.

Original languageEnglish (US)
Pages (from-to)1619-1624
Number of pages6
JournalResuscitation
Volume84
Issue number11
DOIs
StatePublished - Nov 1 2013

Fingerprint

Induced Hypothermia
Hot Temperature
Maintenance
Equipment and Supplies
Temperature
Shivering
Swine
Rewarming
Intratracheal Intubation
Isoflurane
Suction
Clinical Protocols
Hypothermia
Esophagus
Animal Models

Keywords

  • Cooling
  • Esophageal
  • Medical device
  • Swine mode
  • Temperature maintenance
  • Therapeutic hypothermia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Induction, maintenance, and reversal of therapeutic hypothermia with an esophageal heat transfer device. / Kulstad, Erik; Metzger, Anja K.; Courtney, D. Mark; Rees, Jennifer; Shanley, Patrick; Matsuura, Timothy; McKnite, Scott; Lurie, Keith.

In: Resuscitation, Vol. 84, No. 11, 01.11.2013, p. 1619-1624.

Research output: Contribution to journalArticle

Kulstad, E, Metzger, AK, Courtney, DM, Rees, J, Shanley, P, Matsuura, T, McKnite, S & Lurie, K 2013, 'Induction, maintenance, and reversal of therapeutic hypothermia with an esophageal heat transfer device', Resuscitation, vol. 84, no. 11, pp. 1619-1624. https://doi.org/10.1016/j.resuscitation.2013.06.019
Kulstad, Erik ; Metzger, Anja K. ; Courtney, D. Mark ; Rees, Jennifer ; Shanley, Patrick ; Matsuura, Timothy ; McKnite, Scott ; Lurie, Keith. / Induction, maintenance, and reversal of therapeutic hypothermia with an esophageal heat transfer device. In: Resuscitation. 2013 ; Vol. 84, No. 11. pp. 1619-1624.
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AU - Matsuura, Timothy

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AB - Aim of the study: To evaluate a novel esophageal heat transfer device for use in inducing, maintaining, and reversing hypothermia. We hypothesized that this device could successfully induce, maintain (within a 1. °C range of goal temperature), and reverse, mild therapeutic hypothermia in a large animal model over a 30-h treatment protocol. Methods: Five female Yorkshire swine, weighing a mean of 65. kg (range 61-70). kg each, were anesthetized with inhalational isoflurane via endotracheal intubation and instrumented. The esophageal device was connected to an external chiller and then placed into the esophagus and connected to wall suction. Reduction to goal temperature was achieved by setting the chiller to cooling mode, and a 24. h cooling protocol was completed before rewarming and recovering the animals. Histopathologic analysis was scheduled for 3-14 days after protocol completion. Results: Average baseline temperature for the 5 animals was 38.6. °C (range 38.1-39.2. °C). All swine were cooled successfully, with average rate of temperature decrease of 1.3. °C/h (range 1.1-1.9). °C/h. Standard deviation from goal temperature averaged 0.2. °C throughout the steady-state maintenance phase, and no treatment for shivering was necessary during the protocol. Histopathology of esophageal tissue showed no adverse effects from the device. Conclusion: A new esophageal heat transfer device successfully and safely induced, maintained, and reversed therapeutic hypothermia in large swine. Goal temperature was maintained within a narrow range, and thermogenic shivering did not occur. These findings suggest a useful new modality to induce therapeutic hypothermia.

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