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New Intra-Nasal Cooling System May Improve Survival When Initiated Soon After Cardiac Arrest
Date:8/16/2010

r in the group receiving pre-hospital cooling with RhinoChill. Target core body temperature was also reached two hours earlier. Among patients surviving as far as hospital admission, 47% of patients who were cooled survived to discharge, compared with only 31% of those who had not been cooled. Survival rates in the 75% of patients who received CPR within ten minutes of collapse were 59% and 29% respectively.

37% of those cooled intranasally during the arrest survived neurologically intact, compared with only 21% of those not cooled in the field. Neurologically intact survival rates in patients who received CPR within ten minutes of collapse were 46% and 18% respectively, a very significant difference.

"In this study, early cooling of the brain combined with early CPR favorably affected outcomes, irrespective of rhythm," commented PRINCE lead investigator, Dr. Maaret Castren of the Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden and the Department of Emergency Medicine, Sodersjukhuset. "We believe that this study demonstrates that making every attempt to initiate both CPR and intra-arrest cooling as early as possible in the resuscitation process should be adopted."

In an accompanying editorial to the PRINCE study published in Circulation, Dr. Lance Becker from the University of Pennsylvania observes that: 'Although the numbers are too small to reach significance, they provide some tantalizing cooling rates and survival trends that suggest that improved outcomes from intra-arrest nasal cooling may be found in a larger clinical trial.'

He also comments that: 'A strength of this approach [RhinoChill] appears to be its relative noninvasiveness and ease of administration. It may prove an ideal device for the emergency medical services setting.'

The RhinoChill Intra-Nasal Cooling System uses a non-invasive nasal catheter to spray a rapidly evaporating coolant liquid into the nasal cavity. This la
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SOURCE Circulation
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