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The esophageal cooling device: A new temperature control tool in the intensivist's arsenal
Ahmed F Hegazy1, Danielle M Lapierre1, Ron Butler1
1Department of Anesthesia and Perioperative Medicine, University of Western Ontario, LHSC-UC, 339 Windermere Road, London, Ontario N6A 5A5, Canada.
Background:
Therapeutic hypothermia has been demonstrated to improve neurological outcome in comatose survivors of cardiac arrest. Current temperature control modalities however, have several limitations. Exploring innovative methods of temperature management has become a necessity.
Methods:
We describe the first use of a novel esophageal cooling device as a sole modality for hypothermia induction, maintenance and rewarming in a series of four postcardiac arrest patients. The device was inserted in a manner similar to standard orogastric tubes and connected to an external heat exchange unit.
Results:
A mean cooling rate of 0.42 °C/hr (SD ± 0.26) was observed. An average of 4 hr 24 min (SD ± 2 hr 6 min) was required to reach target temperature, and this was maintained 90.25% (SD ± 16.20%) of the hypothermia protocol duration. No adverse events related to device use were encountered. Questionnaires administered to ICU nursing staff regarding ease-of-use of the device and its performance were rated as favorable.
Conclusions:
When used as a sole modality, objective performance parameters of the esophageal-cooling device were found to be comparable to standard temperature control methods. More research is required to further quantify efficacy, safety, assess utility in other patient populations, and examine patient outcomes with device use in comparison to standard temperature control modalities.