Development of a Moderate Therapeutic Hypothermia Induction and Maintenance System for the Treatment of Traumatic Brain Injury

Therapeutic Hypothermia is a technique that involves an intentional and controlled, systemic or selective body cooling, for the treatment of conditions such as traumatic brain injury, stroke, and after cardiopulmonary resuscitation. Decreasing body temperature to below normal levels is a proven clinical intervention and has been used in operating rooms since the 1950s and in the early twenty-first century gained recognition as a neuroprotective agent. There are currently several cooling techniques available which can be invasive or non-invasive, each one has its advantages and disadvantages. The ideal method would be one capable of rapidly inducing hypothermia without risk of overcooling, maintaining the target temperature during the maintenance phase, with minimal oscillation, providing controlled and slow rewarming and being minimally invasive. Each case should be evaluated individually to define the best cooling method to be used. This paper presents a new low cost, safe and easy operation equipment of induction and maintenance of moderate Therapeutic Hypothermia. The system involves direct cooling of the blood through cardiopulmonary bypass, using the same blood lines from hemodialysis procedures, which are fitted in heat exchangers, so that blood cooling occurs within the circuit itself and no contact with any other equipment. The central function of this equipment is to decrease the patient's systemic temperature in order to reach the pre-set target temperature of hypothermia as rapid as possible (induction phase), control the hypothermic temperature precisely to maintain minimal fluctuation (maintenance phase) and slow and controlled rewarming of the patient until the normothermia (rewarming phase).