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Neurocritical Care

, Volume 20, Issue 1, pp 98–105 | Cite as

Safety Evaluation of Nasopharyngeal Cooling (RhinoChill®) in Stroke Patients: An Observational Study

  • Sven Poli
  • Jan Purrucker
  • Miriam Priglinger
  • Marek Sykora
  • Jennifer Diedler
  • André Rupp
  • Cem Bulut
  • Werner Hacke
  • Christian Hametner
Take Notice Technology

Abstract

Introduction

New technologies for therapeutic cooling have become available. The objective of our study was to investigate the safety of nasopharyngeal cooling with the RhinoChill® device in stroke patients, focusing on systemic and neurovital parameters.

Methods

In this prospective observational study, consecutive patients with severe ischemic or hemorrhagic stroke who underwent intracranial pressure (ICP) and brain temperature monitoring have been enrolled. Ten patients who were treated with the RhinoChill® device were analyzed. Brain and bladder temperature and systemic and neurovital parameters were monitored continuously. Additional evaluations of safety included bleeding complications and otolaryngological examinations.

Results

Baseline brain temperature of 36.7 °C (SD 0.9) decreased by an average of 1.21 °C (SD 0.46) within 1 h, the effect of brain temperature decrease ranged from a maximum of 2 °C (patients 3 and 7) to a minimum of 0.6 °C (patient 4). Within the first several minutes after initiating RhinoChill® treatment, 3 of 10 patients experienced an increase in systolic arterial pressure by 30, 30, and 53 mmHg, respectively. Heart rate rose as well (mean 3 bpm, SD 2.9). ICP and oxygen saturation were unaffected by the treatment. We observed 1 bleeding complication in the control CT scan of patient 10. Rhinoscopical findings 3 days after nasopharyngeal cooling and at the follow-up (>6 months) and a 16-item smell test were normal.

Conclusion

The RhinoChill® system cools the brain efficiently. However, steep increases in blood pressure raise serious concerns regarding the safety of its use in stroke patients.

Keywords

Induction of cooling Nasopharyngeal cooling RhinoChill® Hypothermia Normothermia Stroke Brain temperature 

Notes

Funding

No financial support. The RhinoChill® system and supplies were allocated by BeneChill, Inc., San Diego, CA, USA.

Conflict of interest

Sven Poli received speaker’s honoraria from C.R. Bard, BeneChill, EMCOOLs, and ZOLL Medical, project funding from ZOLL Medical and EMCOOLs, and supplies and equipment from BeneChill, Covidien, EMCOOLs, HVM Medical, Raumedic, and ZOLL Medical. Jan Purrucker, Miriam Priglinger, Marek Sykora, Jennifer Diedler, André Rupp, Cem Bulut, Werner Hacke, and Christian Hametner declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Sven Poli
    • 1
    • 2
  • Jan Purrucker
    • 1
  • Miriam Priglinger
    • 1
  • Marek Sykora
    • 1
  • Jennifer Diedler
    • 1
    • 2
  • André Rupp
    • 1
  • Cem Bulut
    • 3
  • Werner Hacke
    • 1
  • Christian Hametner
    • 1
  1. 1.Department of NeurologyHeidelberg UniversityHeidelbergGermany
  2. 2.Department of Vascular NeurologyTuebingen UniversityTübingenGermany
  3. 3.Department of ENTHeidelberg UniversityHeidelbergGermany

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