Medical device for intrathecal cerebral cooling and methods of use

• US 20020091356A1
• Filed: 03/05/2002
• Published: 07/11/2002
• Est. Priority Date: 03/01/1999
• Status: Active Grant

• Current Assignee: Zoll Circulation Incorporated (Asahi Kasei Corporation)
• Original Assignee: Coaxis Incorporated (Trimble Inc.)
• Inventors: Barbut, Denise R., Heinemann, Mark-Hein, Patterson, Russel H.
• Granted Patent: US 6,758,832 B2
• Time in Patent Office: Days
• US Class Current: 604/113
• CPC Class Codes: A61B 2010/008 Interstitial fluid
• CPC Class Codes: A61F 2007/126 for invasive application, e.g. for introducing into blood vessels
• CPC Class Codes: A61M 1/77 Suction-irrigation systems aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463
• CPC Class Codes: A61M 2210/0693 Brain, cerebrum
• CPC Class Codes: A61M 2210/1003 Spinal column
• CPC Class Codes: A61M 27/006 Cerebrospinal drainage; Accessories therefor, e.g. valves

Abstract

The invention provides a medical device having two elongate catheters, a pump, and a refrigeration system. Each catheter has a proximal end, a distal end, a lumen therebetween and communicating with a distal port. The proximal ends of the catheters are connected to the pump and the refrigeration system. The distal ends are adapted for insertion into the subarachnoid space. The cerebral spinal fluid is aspirated from the first catheter to the pump, cooled to below body temperature, and returned to the second catheter. The flow rate of the cerebral spinal fluid is adjusted according the CSF pressure and temperature. Also described are methods of using the devices in treating patients suffering from neurologic complications that arise as a result of inadequate cerebral perfusion, such as cardiac arrest, cardiac failure, low cardiac output states, stroke, head injury, cerebral aneurysm surgery, open and closed cardiac surgery and aortic surgery.

Claims

1. A method for preventing neurologic damage, comprising the steps of:

providing first and second elongate tubular members, each member having a lumen communicating with a port at a distal end;

inserting the first tubular member into the spinal subarachnoid space;

inserting the second tubular member into the spinal subarachnoid space, and advancing the distal port cephalad into the cerebellomedullary cistern;

aspirating or draining cerebral spinal fluid (CSF) through one of the first tubular member or second tubular member;

cooling the CSF by extracorporeal refrigeration; and

perfusing the CSF through the other of the first tubular member or second tubular member.

2. The method of claim 1, wherein the brain is cooled to below normal body temperature.

3. The method of claim 1, wherein CSF pressure is reduced to and maintained at a level substantially below normal CSF pressure.

4. The method of claim 1, wherein the first tubular member is inserted between spinous processes of two cervical vertebrae.

5. The method of claim 1, wherein the first tubular member is inserted between lumbar vertebrae into the subarachnoid space.

6. The method of claim 1, wherein the second tubular member is inserted in the cervical region into the spinal subarachnoid space, and advanced cephalad through the foramen magnum at least as far as the cerebellomedullary cistern.

7. The method of claim 1, wherein the first and second tubular members are inserted over a needle

8. The method of claim 1, further comprising the step of measuring CSF pressure using a manometer.

9. The method of claim 1, further comprising the step of releasing CSF to reduce the pressure in the subarachnoid space.

10. The method of claim 1, further comprising the step of mixing CSF with Ringer'"'"'s lactate solution

11. The method of claim 1, further comprising the step of adjusting the CSF flow rate.

12. The method of claim 1, further comprising the step of measuring CSF temperature.

13. The method of claim 1, further comprising the step of infusing fluid or neuroprotective agent into the subarachnoid space.

14. The method of claim 1, wherein the distal port of the second tubular member is positioned in the cerebellomedullary cistern.