Non-invasive systems, devices, and methods for selective brain cooling

Abstract

Methods, systems, and devices are disclosed for providing selective and non-selective cooling and warming of a patient. Multiple embodiments of devices are disclosed for performing rapid induction and maintenance of therapeutic hypothermia either in a hospital setting or in the field so that hypothermic treatment can be quickly instituted before significant tissue damage occurs. Methods are also disclosed for targeting brain cooling by irrigating the upper airway, aerodigestive tract, and/or more generalized cooling by irrigating the esophagus and/or stomach.

1 . An apparatus for selective and non-invasive cooling of the brain in intubated patients comprising:
 at least one nasal catheter sized to be introduced through the nostrils of a patient;   at least one multi-lumen esophageal catheter sized to be inserted into the esophagus of the patient, the esophageal catheter having a distal end and a proximal end, the distal end configured to extend past the aortic arch of the patient, the esophageal catheter comprising a first lumen, a second lumen, and a third lumen, the first lumen of the esophageal catheter extending from the proximal end to the distal end to provide access to the stomach when the esophageal catheter is disposed in the esophagus of a patient, the second lumen of the esophageal catheter extending from the proximal end and terminating inside a first esophageal inflatable member near the distal end of the esophageal catheter, and the third lumen of the esophageal catheter extending from the proximal end to a port located proximal to the first esophageal inflatable member.   
     
     
         2 . The apparatus of  claim 1 , where the at least one multi-lumen tracheal catheter further comprises:
 a third lumen extending from the proximal end of the catheter to a port located proximal to the first tracheal inflatable member.   
     
     
         3 . The apparatus of  claim 1 , where the esophageal catheter further comprises a fourth lumen, the fourth lumen of the esophageal catheter extending from the proximal end and terminating inside a second esophageal inflatable member near the distal end of the esophageal catheter. 
     
     
         4 . The apparatus of  claim 3 , where the esophageal catheter further comprises a port positioned between the first and second esophageal inflatable members. 
     
     
         5 . The apparatus of  claim 1 , where the tracheal catheter further comprises a fourth lumen, the fourth lumen of the tracheal catheter extending from the proximal end and terminating inside a second tracheal inflatable member near the distal end of the tracheal catheter. 
     
     
         6 . The apparatus of  claim 5 , where the tracheal catheter further comprises a port positioned between the first and second tracheal inflatable members. 
     
     
         7 . The apparatus of  claim 1 , further comprising at least one oral catheter sized to be received in the oral cavity, oropharynx, or hypopharynx of the patient. 
     
     
         8 - 9 . (canceled) 
     
     
         10 . The apparatus of claim  8 , further comprising a filter module positioned between the recirculation reservoir and the oral catheter. 
     
     
         11 . The apparatus of claim  9 , where the discard location comprises a waste reservoir, the waste reservoir having a capacity of between 1 and 20 liters and being maintained at or below atmospheric pressure. 
     
     
         12 . (canceled) 
     
     
         13 . The apparatus of  claim 12 , where the waste reservoir includes a vent that is movable between an open and a closed position. 
     
     
         14 . (canceled) 
     
     
         15 . The apparatus of  claim 14 , where the cooling unit is reusable. 
     
     
         16 . (canceled) 
     
     
         17 . The apparatus of  claim 14 , wherein the cooling unit is in thermal contact but not fluidic contact with the at least one heat exchanger. 
     
     
         18 . (canceled) 
     
     
         19 . The apparatus of  claim 14 , further comprising at least one a temperature monitoring device configured to obtain temperature information and a temperature display configured to display the temperature information. 
     
     
         20 - 21 . (canceled) 
     
     
         22 . The apparatus of claim  21 , where the control unit is configured to receive a target temperature and turn on, turn off, or vary the speed of the at least one pump to adjust a temperature obtained by the temperature monitoring device in consideration of the target temperature. 
     
     
         23 . The apparatus of claim  21 , where the control unit is configured to receive a target flow rate and one or more flow meters are provided to one or more of the nasal catheter, the esophageal catheter, and the tracheal catheter entering the patient and/or one or more catheters leaving the patient, the control unit being configured to adjust a flow rate based on the target flow rate and information obtained by the one or more flow meters. 
     
     
         24 - 25 . (canceled) 
     
     
         26 . The apparatus of claim  25 , where an additional pump is used to drive fluid from the patient into a waste reservoir or a recirculation reservoir. 
     
     
         27 . (canceled) 
     
     
         28 . The apparatus of  claim 1 , further comprising a head warming member, the head warming member comprising a cap or a device configured to deliver thermal energy to the head. 
     
     
         29 . The apparatus of  claim 1 , further comprising a catchment under portions of the neck and/or head that collects fluid that leaves the body via the mouth or nose. 
     
     
         30 - 31 . (canceled) 
     
     
         32 . The apparatus of  claim 1 , further comprising one or more surface warming devices, where the one or more warming devices is configured to be heated by one or more of warm air, warm fluid, thermal radiation, and resistive heating. 
     
     
         33 - 61 . (canceled) 
     
     
         62 . A method for cooling the brain, comprising:
 directing a non-nebulized free flowing fluid through a plurality of catheters into the aerodigestive tract of a patient;   removing the fluid from the aerodigestive tract of the patient through at least one of the plurality of catheters; and   recirculating the fluid through the plurality of catheters until reaching a brain to body core temperature gradient of at least 3° C.   
     
     
         63 - 183 . (canceled) 
     
     
         184 . The method of  claim 62 , further comprising:
 positioning an external warming device on the patient's body to maintain body core temperature higher than a temperature of the brain.