Brain temperature in healthy volunteers subjected to intranasal cooling

• Published in: Intensive care medicine Vol. 37; no. 8; p. 1277
• Main Authors: Covaciu, Lucian, Weis, Jan, Bengtsson, Caroline, Allers, Mats, Lunderquist, Anders, Ahlström, Håkan, Rubertsson, Sten
• Format: Journal Article
• Language: English
• Published: 2011
• Subjects: Anaesthesiology and Intensive Care; Anaesthetics and intensive care; Anestesiologi och intensivvård; Brain temperature; Intensive care; Intensivvård; Kirurgi; Magnetic resonance spectroscopy; MEDICIN; MEDICINE; selective brain cooling; Surgery; Therapeutic hypothermia; trigeminal reflex
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-011-2264-7

Purpose: Intranasal cooling can be used to initiate therapeutic hypothermia. However, direct measurement of brain temperature is difficult and the intra-cerebral distribution of temperature changes with cooling is unknown. The purpose of this study was to measure the brain temperature of human volunteers subjected to intranasal cooling using non-invasive magnetic resonance (MR) methods. Methods: Intranasal balloons catheters circulated with saline at 20 °C were applied for 60 min in 10 healthy, unsedated volunteers. Brain temperature changes were measured and mapped using MR spectroscopic imaging (MRSI) and phase-mapping techniques. Heart rate and blood pressure were monitored throughout the experiment. Rectal temperature was measured before and after the cooling. Mini Mental State Examination (MMSE) test and nasal inspection were done before and after the cooling. Questionnaires about the subjects personal experience were filled after the experiment. Results: Brain temperature decrease measured by MRSI was -1.7 ± 0.8°C and by phase-mapping -1.8 ± 0.9°C at the end of cooling. Spatial distribution of temperature changes was relatively uniform. Rectal temperature decreased by -0.5 ± 0.3°C. The physiological parameters were stable and no shivering was reported. The volunteers remained alert during cooling and no cognitive dysfunctions were apparent at MMSE test. Postcooling nasal examination detected increased nasal secretion in 9 of the 10 volunteers. Volunteer’s acceptance of the method was good.    Conclusion: Both MR techniques revealed brain temperature reductions after 60 min intranasal cooling with balloons circulated with saline at 20 °C in healthy and unsedated volunteers.