Induction of Cooling With a Passive Head and Neck Cooling Device

Therapeutic hypothermia improves clinical outcome in patients with global cerebral ischemia after cardiac arrest and in newborns with hypoxic ischemic encephalopathy. Hypothermia also seems promising in other cerebrovascular diseases, for example, ischemic and hemorrhagic stroke. In experimental models, the sooner hypothermia was initiated, the more distinctive neuroprotection was. Although clinical proof is still missing, experimental data supports the concept of prehospital induction of cooling. Induction methods should be easily applicable, transportable, safe, and effective in brain cooling. Head cooling devices seem suitable for this purpose. However, the results from the few published clinical trials evaluating cooling efficacy directly in the brain are conflicting. Theoretical evaluation indicates superiority of combined head and neck cooling compared with pure head cooling only. Hence, the Sovika cooling device (HVM Medical, Rotenburg, Germany) covering not only the head but also the anterior and dorsal neck seems promising. Two recent studies in healthy volunteers showed contradictory data regarding safety. Unfortunately, both trials were limited to monitoring peripheral temperatures only instead of the actual brain temperature. The aim of our study was to investigate whether the Sovika head and neck cooling device is effective in lowering brain temperature.