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 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 when the esophageal catheter is disposed in a 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;   at least one multi-lumen tracheal catheter sized to be inserted into the trachea of the patient, the tracheal catheter comprising a first lumen and a second lumen, the first lumen of the tracheal catheter extending from a proximal end to a distal end of the catheter to provide access to the lungs to allow the passage of air into and out of the lungs when the tracheal catheter is disposed in the trachea of a patient and the second lumen of the tracheal catheter extending from the proximal end of the catheter and terminating inside a first tracheal inflatable member near the distal end of the catheter;   a cooling system coupled to a recirculation reservoir for recirculation of a free flowing fluid to the patient, the cooling system comprising:
 a cooling unit and at least one heat exchanger, the at least one heat exchanger being configured to exchange thermal energy with the reusable cooling unit; 
 at least one of a temperature monitoring device configured to obtain temperature information and a temperature display configured to display the temperature information; 
 a control unit for controlling a cooling operation based on the temperature information received by the temperature monitoring device; 
   wherein the apparatus is configured to:
 direct the free flowing fluid from the cooling system through at least the third lumen of the multi-lumen esophageal catheter into an aerodigestive tract of a patient; 
 return the fluid from the aerodigestive tract of the patient to the cooling system through at least one oral catheter; and 
 recirculate the fluid into the aerodigestive tract until reaching at least one of a brain to body core temperature gradient of at least 3° C. or a jugular bulb to body core temperature gradient of at least 3° C. 
   
     
     
         2 .- 21 . (canceled) 
     
     
         22 . The apparatus of  claim 1 , where the control unit is configured to receive a target temperature and turn on, turn off, or vary the speed of 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 1 , 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 . The apparatus of  claim 22 , where the at least one pump comprises at least one of a centrifugal pump, a rotary pump, a diaphragm pump, a gear pump, and a peristaltic pump. 
     
     
         25 . The apparatus of  claim 1 , where a ratio of flow directed to the esophageal catheter relative to that directed toward the at least one nasal catheter is controlled by two separate pumps, the two pumps being configured to propel fluid into the patient via the esophageal catheter and at least one nasal catheter, respectively. 
     
     
         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 . The apparatus of  claim 1 , further comprising a head cooling member, the head cooling member including a cooling cap or a device configured to deliver cold liquid to the head. 
     
     
         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 . The apparatus of  claim 29 , where the catchment is in fluidic communication with a recirculation reservoir or a waste reservoir. 
     
     
         31 . The apparatus of  claim 1 , further comprising one or more surface warming devices. 
     
     
         32 . The apparatus of  claim 31 , where the warming device is configured to be heated by one or more of warm air, warm fluid, thermal radiation, and resistive heating. 
     
     
         33 . The apparatus of  claim 32 , where the warming device comprises a warming blanket. 
     
     
         34 . The apparatus of  claim 32 , where the warming device comprises a warming helmet. 
     
     
         35 .- 183 . (canceled)