How hypothermia can heal
By Kristina Klosowski, Behavioral Neuroscience, 2021
Have you ever heard the saying, “you’re not dead until you’re warm and dead”? This is because short periods of hypothermia can slow metabolic processes down to the point where the brain requires a reduced level of oxygen.
Hypothermia is a condition in which your body loses heat faster than it can be produced. Generally, you are considered to be hypothermic if your body temperature falls below 95 degrees Fahrenheit (normal body temperature in humans is 98.6 degrees Fahrenheit). While the process is not entirely understood, this is thought to be why you may have heard amazing stories of people surviving after having fallen under the ice for prolonged periods of time, and recovering with relatively minimal brain damage.
While prolonged hypothermia will certainly result in injury and death, short periods of mild hypothermia can actually be therapeutic.
While prolonged hypothermia will certainly result in injury and death, short periods of mild hypothermia can actually be therapeutic. The beginning of therapeutic hypothermia (also called targeted temperature management) actually traces back thousands of years, but its uses in modern medicine have been developed mostly throughout the 20th and into the 21st century. Today, it is most widely used in the care of cardiac arrest patients to improve neurological outcomes.
Several different types of neurological deficits occur after cardiac arrest. One is known as hypoxic injury, which is caused by lack of oxygen. Lack of oxygen disrupts several cellular processes and will eventually lead to apoptosis, or programmed cell death (also referred to as cellular suicide). Unfortunately, when apoptosis occurs and a cell ruptures, the contents of the cell leak out and can cause more damage and can trigger an inflammatory response. This is particularly detrimental in the brain, where even a minor swelling response can cause substantial brain damage. Hypothermia combats this by counteracting the excitatory response that leads to cell death. It also reduces the severity of the inflammatory response of the immune system in the brain.
Recently, the idea of selectively cooling the brain has taken hold in expanding treatment options for other severe conditions. Selective brain cooling in traumatic brain injury (TBI) is being studied at Vivonics, Inc., a small medical device company whose mission is to develop innovative technologies to improve human health and performance. Vivonics has received grants from the Department of Defense (DoD) to research and develop products that are intended for use in the field. Since DoD personnel are at a higher risk for traumatic brain injury due to the nature of their job, a need was identified for a technology that could mitigate the secondary effects of TBI, and was designed with field use in mind.
Recently, the idea of selectively cooling the brain has taken hold in expanding treatment options for other severe conditions.
Meet ICEPICC. Short for Intranasal Cooler for Encephalopathy Prevention in Combat Casualty, ICEPICC is a hand-held intranasal cooling system; an easy-to-operate technology that marries an expertise in traumatic brain injury with the ever-growing need for better combat casualty care. It has been shown to provide effective cooling through a forced cold-air convection system, which delivers cooled air to the brain via a nasal cannula. By cooling the brain to normothermic — normal body temperatures — or mildly hypothermic temperatures, the inflammatory response that occurs after a TBI can be quelled. This plays a huge role in reducing the severity of any brain damage that occurs, as well as reducing the risk of mortality.
As Gordan Hisrchman, the CEO, president, and founder of Vivonics explains, “when someone suffers a head injury, there can be both immediate damage to the brain as well as secondary damage that occurs after the initial trauma. Our ICEPICC intranasal cooling system can help minimize the secondary damage if applied promptly after the initial injury, greatly improving outcomes in cases of traumatic brain injury.”
Though not yet FDA-approved, ICEPICC is still under development by a skilled team of engineers. This exciting innovation is an example of the evolution of therapeutic hypothermia and its many potential applications in modern medicine.
