A study comparing conventional brain cooling with trans-nasal cooling.
Research type
Research Study
Full title
Randomised prospective pilot study comparing conventional brain cooling with additional early trans-nasal cooling prior to surgery on the ascending aorta/proximal aortic arch.
IRAS ID
146648
Contact name
Paul D Waterworth
Contact email
Sponsor organisation
University Hospital of South Manchester NHS Foundation Trust
Research summary
Both temporary and permanent neurological dysfunction is frequently encountered after surgery on the aortic arch. Aneurysms of the ascending aorta often extend into the proximal aortic arch. In such cases, the proximal aortic arch (hemi arch replacement) can only be replaced if the aortic cross clamp is removed and the aortic arch is opened. In this situation cerebral protection is vital to minimise the neurological deficit.
It is standard practice when performing a hemi arch replacement to cool the patient systemically to 15C after commencement of the heart and lung bypass machine. Once the patient's body temperature reaches 15C; the heart and lung machine is switched off and the patient's circulation is arrested. This is known as deep hypothermic circulatory arrest (DHCA).
Recent animal studies with the intra-nasal cooling have suggested that effective brain cooling can be achieved via the trans-nasal route and that early onset of the trans-nasal cooling has been beneficial in the Emergency Room setting in reducing brain damage in patients with cardiac arrest.
The aim of this study is to determine whether trans-nasal brain cooling commenced in the anaesthetic room prior to the commencement of the heart and lung bypass is effective in reducing cognitive and neurological dysfunction after aortic root/arch surgery.REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
14/NW/0253
Date of REC Opinion
8 Jul 2014
REC opinion
Further Information Favourable Opinion