Technology for Inducing Mild Therapeutic Hypothermia

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The rapid increase in prevalence of chronic diseases throughout the world represents an ongoing concern for public health experts and physicians. Heart attacks are one of the leading factors responsible for high mortality and morbidity rates of cardiovascular diseases. According to the NIH, around 1.2 million Americans suffer from heart attacks every year. While not always necessarily leading to death, myocardial infarctions can still have debilitating, long-lasting negative effects on patients.

Numerous studies have demonstrated that mild therapeutic hypothermia can play a significant role in improving patient outcomes after a heart attack and in reducing the size of the infarct. What is mild therapeutic hypothermia? Effectively, it is cooling the body to a temperature of between 32 to 35 degrees Celsius. One swine model study showed a reduction in infarct size of 43 percent; this study used a method of endovascular cooling to induce mild therapeutic hypothermia. Analysis of clinical trials showed that initiating therapeutic hypothermia prior to restoration of blood flow was critical in improving outcomes and reducing infarct size.

The cooling of the body performs a dual function after a heart attack – it reduces both the damage to cells resulting from blood loss and the damage from reperfusion. Reperfusion refers to the restoration of the blood supply, which occurs upon medical intervention. Effectively, the cooling technology reduces metabolic rates and reduces the inflammation that causes blockages. I did not realize the extent to which damage from reperfusion can impact long term outcomes for patients; the cooling technology can reduce the cell death that can often occur from reperfusion.

One interesting technological development I recently discovered, which prompts mild therapeutic hypothermia, is a device from a company called Velomedix. Their Velomedix System reduces body temperature to a target of around 33 degrees Celsius in less than 15 minutes. This is crucial because the goal is to induce mild hypothermia without significantly extending the time it takes to restore blood flow. This technology from Velomedix is unique from other methods of producing mild hypothermia, as it does not involve skin or endovascular cooling. In order to initiate cooling in a rapid 15-minute timeframe, cold fluid is circulated in the peritoneal cavity using a peritoneal catheter. Since the system is near many of the internal organs of the body, it allows for a quick and effective transfer of heat to cool the body. The company describes this as being similar to peritoneal dialysis.

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Image courtesy of Velomedix.

While Velomedix is currently focusing on improving outcomes for those suffering from heart attacks, they eventually plan to focus on strokes and brain injuries as well so as to improve patient prognosis. I find it quite exciting that clinical trials of this technology have already begun in the United States and Canada. The trials began enrolling patients in February of this year and will focus on inducing mild therapeutic hypothermia in those patients with the most severe form of heart attacks. The speed and unique design of Velomedix’s technology seems to show great promise for the future.  Especially with the increase in cardiovascular diseases, this technology could not arrive at a better time. After witnessing the damaging effects of a heart attack myself, technology that can ameliorate patient outcomes and improve long-term prognosis for heart attack victims is greatly needed.