CN105307564A - 脑脊液冷却装置 - Google Patents
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Abstract
一种用于使用固体导热材料通过冷却脑脊液或CSF来局部冷却神经系统的装置。该固体导热材料联接到热交换设备。可将该导热材料联接到可在现有的用于急性神经损伤的临床护理标准中使用的任何导管，例如用于监测和缓解颅内压的导管。该导热材料是生物相容性的和固体的材料，例如诸如钢、钨和钛的金属，以及是非金属材料，例如热金刚石研磨膏。
Description
相关专利申请的交叉引用
本专利申请要求美国临时专利申请61/814,964的优先权。
技术领域
本发明涉及用于诱导降低体温的装置。
背景技术
中风、创伤性脑损伤和脊髓损伤通常对脊髓和脑部构成永久性损伤的显著风险。类似地，包括但不限于心脏疾病、心脏停搏和大手术的多种疾病/事件/程序，可继之以脑部和脊髓局部缺血，这继而可导致永久性神经损伤。由局部缺血、中风、出血或创伤引起的严重脑损伤的恢复是罕见的。神经损伤的持久性和无法医治性质要求快速减轻治疗和护理。
长期以来大家一直认为降低体温可减轻脑损伤。心脏停搏后经由适度降低体温的治疗最初报道于1950年代末和1960年代初。心脏停搏后降低体温研究组。适度治疗性降低体温以改善心脏停搏后的神经系统后果("MildTherapeuticHypothermiatoImprovetheNeurologicOutcomeafterCardiacArrest.")《新英格兰医药杂志》(NewEnglandJournalofMedicine)346.8(2002):549-56。其益处的原因尚未得以证实，但是诱导适度的降低体温已被假设用于在多种类型的脑损伤(包括创伤性脑损伤、缺血性中风、颅内出血和肝性脑病)中显著降低颅内压和次级神经损伤。因此，降低体温仍旧是预防、保护或减轻神经损伤的有希望的工具。
事实上，诱导全身的降低体温，即诱导整个身体降低体温，是管理心脏停搏的幸存患者的可接受的初始步骤。用于诱导全身降低体温的装置包括冷却垫和血管导管。然而，全身降低体温与许多副作用相关联，所述副作用包括出血性素质、战栗、心率失常、免疫系统抑制(所述免疫系统抑制导致增加的感染敏感性)和电解质失调。
因此，存在对下述技术越来越大的兴趣，所述技术是在没有全身降低体温的有害副作用的前提下提供神经保护的益处的技术。目前已知的用于神经系统的选择性冷却的装置包括冷却头盔和用于循环冷却盐水的导管，但是具有有限的功效，原因在于未能持续降温或者在于副作用。此外，利用循环液体的方法受液体冰点、以及破裂和污染风险的限制。
发明内容
本发明的目的是选择性地冷却神经系统并且防止神经元损伤，并且目的是使用具有导热特性的材料，所述材料具有更好的冷却功效和对人体更小的损伤风险。本发明是用于通过脑脊液或CSF的冷却来局部冷却神经系统的装置。CSF充当用于脑和脊髓的，并且围绕脑和脊髓循环的缓冲层。本发明使用联接到热交换设备的固体导热材料来冷却周围的CSF。可将该导热材料联接到可在现有的用于急性神经损伤的临床护理标准中使用的任何导管，例如用于监测和缓解颅内压的导管。该导热材料为生物相容性的和固体的材料(例如诸如钢、钨和钛的金属)和非金属材料(例如热金刚石研磨膏)。
附图说明
在下述附图中，类似参考数字已被用于尽可能指示处于不同视角的类似部分：
图1示出了本发明的装置；
图2示出了本发明的导管的横截面；
图3示出了导管插入到脑部侧脑室内；
图4示出了本发明的可替代配置的装置。
具体实施方式
参见图1，本发明的优选的实施例包括引流导管100，该引流导管通常用于在治疗脑损伤和脊髓损伤期间调整脑内压力。该引流导管100典型地插入到脑部的侧脑室500内，如图3所示，并且可包括已知监测传感器，例如压力传感器、氧气监视器和温度计的任何组合。当产生压力时，CSF通过开口200进入导管100并且从头骨流出。
本发明包括固体导热材料300，该固体导热材料可操作用于降低CSF温度。该导热材料为生物相容性材料，即，引起身体产生最小反应的材料。设想了包括金属(例如钨和钛)的导热材料和生物相容性材料，以及碳基材料(例如热金刚石研磨膏或金刚石膜)。优选地，该导热材料不会导致可中断程序(例如MRI)的热磁效应。
该导热材料联接到可操作用以调整材料温度的热交换设备。热交换在本领域中为已知的并且可包括任何流体、气体、电或其他热交换器。在优选的实施例中，该热交换器附接到标准的壁式出口。
该导热材料300位于该导管上用于例如通过使表面面积最大化来优化温度分布。在如图1所示的优选实施例中，该导热材料300位于该导管的端部，并且还位于该导管的外表面上的嵌条中。横截面图2示出了嵌条300如何分布在该导管的外表面之上位于引流开口200之间。尽管希望将该导热材料放置成使得该导管保持柔性的，但是对应本领域的专业人员显而易见的是柔性导管还可被放置在脑内。
在替代性实施例中，如图4所示，本发明包括由导热材料300制成的薄金属框。该导热框可被一次性地或可重复使用地附接到标准引流导管，通过严格的化学或高压灭菌技术进行消毒。该导热框可附接成围绕该导管100的外侧，其中导热帽位于远端。该导热框为柔性的使得它可在隧道式穿过头骨和穿过脑部时使用。
在不脱离本发明的精神的前提下导管和导热材料的许多构型为可能的。例如，该装置可包括中空的并可插入到标准引流导管内的导热元件，其中该可插入的导热元件包括穿孔端，通过所述穿孔端发生脑室引流。一旦颅内压和大气压已经平衡，则将不发生CSF的净流并且当CSF在脑部和脊髓中循环时导热元件将冷却CSF。
在另一个实施例中，该装置可包括用于同时冷却和引流的具有穿孔和导热端的导管，其中，该导管内侧上的线内衬有导热材料。还在另一个实施例中，该导管的端包括导热网格材料的球面以允许用于同时引流和冷却，其中该导热网格可操作用于打开和关闭以最大化或最小化用于冷却的表面面积。
对于普通技术人员显而易见的是，该冷却导管互补于现有和标准侧脑室引流程序、可与现有和标准侧脑室引流程序相容、或者可替代现有和标准侧脑室引流程序，以缓解颅内压。尽管插入到脑室内是缓解颅内压的护理标准，但是本发明的目的是冷却CSF并且如此该导管可被放置在身体中存在CSF的任何位置。
在优选的实施例中，该导管还包括温度传感器以测量周围组织的温度。当在脑中使用时，该温度传感器优选地位于该导管的近端附近，使得它可测量脑组织的温度。在优选的实施例中，该导管还包括在预防神经元损伤的标准程序期间使用的颅内压监测器600。
在不脱离本发明范围的前提下可对本发明做出许多可能的实施例，并且应当理解本文所述的或附图所示的所有事项应当理解为示例性的而非限制性的。
权利要求书(按照条约第19条的修改)
1.一种可插入到脑脊液内的装置，该装置包括联接到热交换设备的固体导热材料，其中该热交换设备可操作用于通过固体传导将热传输到该固体导热材料和/或从该固体导热材料传输热。
2.根据权利要求1所述的装置，包括导管。
3.根据权利要求1所述的装置，包括导管附接件。
4.根据权利要求1所述的装置，能够操作以监测颅内压。
5.根据权利要求1所述的装置，能够操作以引流脑脊液。
6.根据权利要求1所述的装置，包括用于颅内引流的导管。
7.根据权利要求1所述的装置，其中该导热材料为金属。
8.根据权利要求1所述的装置，其中该导热材料为非金属的。
9.一种使用根据权利要求1所述装置的方法，该方法包括步骤(i)将该装置插入到脑脊液内，和步骤(ii)操作该热交换设备以通过固体传导将热传输到该固体导热材料或者从该固体导热材料传输热。
10.根据权利要求9所述的方法，其中该装置包括导管。
11.根据权利要求9所述的方法，其中该装置包括导管附接件。
12.根据权利要求9所述的方法，其中该装置能够操作以监测颅内压。
13.根据权利要求9所述的方法，其中该装置能够操作以引流脑脊液。
14.根据权利要求9所述的方法，其中该装置为用于颅内引流的导管。
15.根据权利要求9所述的方法，其中该导热材料为金属。
16.根据权利要求9所述的方法，其中该导热材料为非金属的。
Claims (16)
1.一种可插入到脑脊液内的装置，该装置包括联接到热交换设备的固体导热材料。
2.根据权利要求1所述的装置，包括导管。
3.根据权利要求1所述的装置，包括导管附接件。
4.根据权利要求1所述的装置，能够操作以监测颅内压。
5.根据权利要求1所述的装置，能够操作以引流脑脊液。
6.根据权利要求1所述的装置，包括用于颅内引流的导管。
7.根据权利要求1所述的装置，其中该导热材料为金属。
8.根据权利要求1所述的装置，其中该导热材料为非金属的。
9.一种使用根据权利要求1所述装置的方法，该方法包括步骤(i)将该装置插入到脑室的脑脊液内，和步骤(ii)操作该热交换设备以冷却该导热材料。
10.根据权利要求9所述的方法，其中该装置包括导管。
11.根据权利要求9所述的方法，其中该装置包括导管附接件。
12.根据权利要求9所述的方法，其中该装置能够操作以监测颅内压。
13.根据权利要求9所述的方法，其中该装置能够操作以引流脑脊液。
14.根据权利要求9所述的方法，其中该装置为用于颅内引流的导管。
15.根据权利要求9所述的方法，其中该导热材料为金属。
16.根据权利要求9所述的方法，其中该导热材料为非金属的。
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| US201361814964P | 2013-04-23 | 2013-04-23 | |
| US61/814,964 | 2013-04-23 | ||
| PCT/US2014/034798 WO2014176162A1 (en) | 2013-04-23 | 2014-04-21 | Cerebrospinal fluid cooling device |
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| Publication Number | Publication Date |
|---|---|
| CN105307564A true CN105307564A (zh) | 2016-02-03 |
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| CN201480034015.8A Pending CN105307564A (zh) | 2013-04-23 | 2014-04-21 | 脑脊液冷却装置 |
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| EP (1) | EP2988663A4 (zh) |
| JP (1) | JP2016522020A (zh) |
| KR (1) | KR20160005049A (zh) |
| CN (1) | CN105307564A (zh) |
| AU (1) | AU2014257323A1 (zh) |
| HK (1) | HK1220881A1 (zh) |
| WO (1) | WO2014176162A1 (zh) |
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| WO2018108120A1 (zh) * | 2016-12-15 | 2018-06-21 | 新海科技集团有限公司 | 一种电子降温仪 |
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| EP3585474A1 (de) * | 2017-02-24 | 2020-01-01 | IPTA GmbH | Vorrichtung für eine gehirndrainage |
| FR3075034B1 (fr) * | 2017-12-18 | 2020-01-10 | Commissariat A L'energie Atomique Et Aux Energies Alternatives | Sonde implantable pour dispositif de refroidissement localise et dispositif incluant ladite sonde |
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| WO2018108120A1 (zh) * | 2016-12-15 | 2018-06-21 | 新海科技集团有限公司 | 一种电子降温仪 |
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| EP2988663A1 (en) | 2016-03-02 |
| WO2014176162A4 (en) | 2015-01-08 |
| HK1220881A1 (zh) | 2017-05-19 |
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| AU2014257323A1 (en) | 2015-11-26 |
| US10485697B2 (en) | 2019-11-26 |
| JP2016522020A (ja) | 2016-07-28 |
| EP2988663A4 (en) | 2016-12-14 |
| KR20160005049A (ko) | 2016-01-13 |
| WO2014176162A1 (en) | 2014-10-30 |
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