Dr. Gary Steinberg

But the operating room staff appropriately didn't like that because alcohol is inflammable.

So then we started using cooling blankets.

And then a number of companies started developing cooling catheters.

And I worked with several of these.

So you can actually cool very quickly if you put a catheter into a vessel, say, in the groin.

and infuse cold saline, which doesn't get into the circulation, but it cools the blood, and the cooled blood then circulates.

Other ways of cooling are to putting on special devices which cool quickly, and that's what's used now are external devices.

People are working on cooling just the head with helmets.

So it's still an active field of investigation for stroke and also for cardiac arrest, actually.

It has not been proven in well-designed prospective trials that it works for garden variety focal stroke.

It works for cardiac arrest where there's global lack of blood flow to the brain, like when the heart stops.

It hasn't been proven yet for the kind of stroke we've been talking about where there's a single blocked artery to the brain.

Yeah.

I mean, I wouldn't recommend if you have a head injury or a TIA to stick your head in a snowbank.

But even with traumatic brain injury, severe, not just concussion, but severe TBI, traumatic brain injury, studies were done looking at cooling, hypothermia, and it's called mild hypothermia because it's just a few degrees.

And the studies were very suggestive, but didn't get to the point that it was proven, although certain subgroups who were cooled quickly seemed to do better.

So I think it's a subject that's still being studied.

And as I say, it's easy for us to do in the operating room.

You don't want to cool too much because that can then interfere with other metabolic functions and clotting parameters.

And it can cause increased infection if you go too low for too long.