What is it about?

The Neurosave system was able to cool the human brain 3 degreeC within 15 minutes, hours faster than market leading technology. During very low blood pressure NeuroSave cooled the brain much faster, an additional 4 degreeC in only 2 minutes. This is the first ever demonstration of this robust and beneficial function in humans . The body core was maintained at least 3.5 degreeC warmer than the brain which may reduce therapy-limiting side effects. The NeuroSave system achieves rapid brain-selective cooling by circulating cold salt water in the nose, throat and upper esophagus in intubated patients. Neurosave does not require skin puncture, blood vessel invasion or dilute the blood unlike more invasive investigational approaches.

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Why is it important?

Brain cooling reduces brain injury after sudden death (cardiac arrest) and birth-related brain damage, cooling the brain may also shrink strokes. However, time is brain and delaying brain cooling may dramatically limit benefit. This small feasibility trial has shown that it is possible to cool the human brain in minutes, a feat impossible with currently marketed cooling technology. It is physically possible to cool human brains almost as early after brain injury as in animal trials. This particular technology cools the brain even faster and more deeply when blood flow to the brain is reduced - 'better when sicker' functionality could greatly broaden the patient populations who might benefit from brain cooling. The cold brain has been shown in a variety of species to be highly robust and salvageable after injury - if cooled early. It now appears possible to cool the human brain early enough to enjoy clinically meaningful benefits.

Perspectives

I am dismayed that clinical trials of brain cooling apply cooling in ways not studied in animal models of brain ischemia. In animal trials brain cooling is typically applied very soon after ischemia, while in human trials up to 10 hours can pass before goal temperature is reached. Time is brain. I believe that clinical application of cooling should attempt to mimic, as closely as possible, the animal trials that have demonstrated dramatic benefit such as shrinking strokes and improving outcomes after cardiac arrest. New technology may be helpful. In this small feasibility trial, it has been shown that the human brain can be cooled within the timeframes used in animal trials. I hope that this technology, and others in development, reignite interest in this important field of study.

Thomas Kreck
NeuroSave Inc.

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This page is a summary of: Selective brain hypothermia: feasibility and safety study of a novel method in five patients, Perfusion, June 2019, SAGE Publications,
DOI: 10.1177/0267659119853950.
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