The effect of thermoelectric craniocerebral cooling device on protecting brain functions in post-cardiac arrest syndrome

Abstract

Aim: This study aimed to protect brain functions in patients who experienced inhospitalcardiac arrest through the application of local cerebral hypothermia. Byutilizing a specialized thermal hypothermia device, this approach sought tomitigate ischemic brain injury associated with post-cardiac arrest syndrome,enhance survival rates, and improve neurological outcomes as measured bystandardized scales.Methods: A prospective, single-center cohort study was conducted involvingpatients aged ≥18 years who experienced in-hospital cardiac arrest and achievedreturn of spontaneous circulation (ROSC). Patients were cooled using ahypothermia helmet to achieve a target temperature of 32°C–34°C, maintainedfor 36–72 h, followed by controlled rewarming and normothermia for 72 h.Neurological recovery was assessed using the Cerebral Performance Category(CPC) scale, where CPC 1–2 denotes good recovery and CPC 3–5 indicates pooroutcomes. Body temperature, hemodynamic parameters, biochemical changes,and survival data were meticulously recorded and analyzed. Statistical analysisincluded paired t-tests to compare pre- and post-treatment data.Results: Of 116 cardiac arrest cases, 30 (25.86%)were in-hospital, and 16 (53.33%) ofthese achieved ROSC. Among the patients, 62.5% underwent emergency coronaryangiography due to ST-elevation myocardial infarction (STEMI). The mean time tohypothermia initiation was 32.9 ± 13.5 min, with hypothermia maintained for58 ± 6.4 h. Neurological outcomes were favorable, with 62.5% of patientsachieving CPC scores of 1 or 2, indicating functional recovery and independence.In contrast, CPC scores of 3 or higher were observed in 37.5% of patients,reflecting varying degrees of disability. Biochemical analysis revealed significantdecreases in sodium, potassium, calcium, and magnesium levels, alongsideincreased urea and creatinine concentrations. Hemodynamic improvementsincluded elevated systolic blood pressure and heart rate, while left ventricularejection fraction remained stable. Overall survival was 75%, and the majority(62.5%) of survivors were discharged without significant neurological deficits.Conclusion: The findings suggest that early and targeted application ofcraniocerebral thermal hypothermia has the potential to improve survival andpreserve neurological function in post-cardiac arrest syndrome. The high ratesof favorable outcomes, as reflected by CPC scores, underscore theneuroprotective effects of localized hypothermia. Further large-scale,multicenter trials are recommended to validate these promising results andrefine protocols for optimal clinical application.KEYWORDScardiac arrest, hypothermia, neurological outcomes, post-resuscitation care, targettemperature management