• Eric J Curran, Daniel L Wolfson, Richard Watts, and Kalev Freeman.
• Department of Surgery, The Robert Larner, M.D. College of Medicine at The University of Vermont, Burlington, VT, USA.
• Neurocrit Care. 2017 Oct 1; 27 (2): 214-219.

BackgroundTargeted temperature management (TTM) confers neurological and survival benefits for post-cardiac arrest patients with return of spontaneous circulation (ROSC) who remain comatose. Specialized equipment for induction of hypothermia is not available in the prehospital setting, and there are no reliable methods for emergency medical services personnel to initiate TTM. We hypothesized that the application of surface cooling elements to the neck will decrease brain temperature and act as initiators of TTM.MethodsMagnetic resonance (MR) spectroscopy was used to evaluate the effect of a carotid surface cooling element on brain temperature in healthy adults.ResultsSix individuals completed this study. We measured a temperature drop of 0.69 ± 0.38 °C (95% CI) in the cortex of the brain following the application of the cooling element. Application of a room temperature element also caused a measurable decrease in brain temperature of 0.66 ± 0.41 °C (95% CI) which may be attributable to baroreceptor activation.ConclusionThe application of surface cooling elements to the neck decreased brain temperature and may serve as a method to initiate TTM in the prehospital setting.

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