Brain temperature changes during selective cooling with endovascular intracarotid cold saline infusion: simulation...

Area of Science:

• Neuroscience
• Medical Engineering
• Therapeutic Hypothermia

Background:

• Cerebral hypothermia is a neuroprotective strategy.
• Rapid induction methods are needed for clinical application.
• Intracarotid cold saline infusion (ICSI) is a potential method.

Purpose of the Study:

• To investigate the feasibility of rapid cerebral hypothermia induction using ICSI in humans.
• To validate a mathematical model for estimating brain temperature changes.
• To assess the safety and efficacy of ICSI in a neuroangiographical setting.

Main Methods:

• Hybrid approach combining jugular venous bulb temperature (JVBT) sampling and mathematical modeling.
• Forward and inverse mathematical modeling of transient and steady-state brain temperature.
• Estimation of ipsilateral anterior circulation territory temperature (IACT) changes in eight patients.

Main Results:

• Measured JVBT dropped by 0.76±0.18°C during ICSI.
• Modeled JVBT decreased by 0.86±0.18°C.
• Modeled IACT decreased by 2.1±0.23°C; inverse model showed a 1.9±0.23°C decrease.

Conclusions:

• Mild cerebral hypothermia can be rapidly and safely induced with ICSI.
• The JVBT-corrected mathematical model provides a non-invasive estimate of cerebral temperature changes.
• ICSI is a promising technique for neuroprotection in neuroangiographical procedures.