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Simple nose spray that could save your life chills the brain

Body
Squirting a cool mist up the nose could be a lifesaver for patients who have had a cardiac arrest.

The mist is delivered through two probes, one in each nostril, and thought to work by chilling the brain, which helps to prevent long-term, and potentially fatal, brain damage.

Rapidly cooling the body is known to help after cardiac arrests, when the heart stops pumping blood, but the equipment currently used is available only in hospitals. This can result in a delay before patients receive treatment, which means they may die or be left with irreparable brain damage as the blood supply is cut off.

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The new hand-held device, called RhinoChill, allows the cooling technique to be started much earlier by paramedics, increasing the chance of a patient surviving and making a full recovery. It may also help patients who have had a stroke or brain injury.

One theory as to why it works is that cooling the body slows the rate at which cells use up energy, which in turn slows the mechanisms that normally lead to damage, giving doctors more time to treat the problem.

A new study shows the device is safe and easy to use after cardiac arrests, and a large study of 900 patients across Europe is under way to assess how well it improves survival rates and whether it reduces brain damage after a cardiac arrest.

More than 60000 people have a cardiac arrest out of hospital each year in the UK and fewer than one in 10 survive. The main causes are a heart attack, where there’s a sudden interruption of the blood supply to part of the heart muscle, or an underlying heart condition.

Studies have shown that cooling the body to 32-34°C (known as hypothermia) can reduce long-term damage to the brain and improve a patient’s chance of a full recovery.

Hospital staff may achieve this using bulky devices which deliver cold saline solution directly into the blood to reduce its temperature. They also use cooling blankets or ice packs.

The new cooling system, known as intra-nasal cooling and designed to be used by paramedics as soon as possible, consists of a machine - roughly the size of a briefcase - which contains a pump and a container full of the coolant liquid.

This machine has a tube which connects it to two probes that are placed inside a patient’s nostrils. Once activated, a constant stream of coolant is sprayed through the probes into the nasal cavity where the blood vessels which supply the brain are.

A recent study at the Medical University of Vienna looked at the use of the device in 21 people who had suffered cardiac arrest and found early use of the device was “feasible, safe, easy to handle, and does not delay or hinder resuscitation”.

The device will now be tested on 900 patients who have had a cardiac arrest, at a number of hospitals across Europe, including the Erasme University Hospital in Belgium.

Commenting on the device, Dr Richard Lyon, a professor of pre-hospital emergency medical care at the University of Surrey, says: “It is potentially an exciting prospect. Intra-nasal cooling has huge potential for the treatment of people with cardiac arrest.

“Animal studies have shown it can be very effective, but the challenge is to start the treatment as soon as possible.” - Daily Mail

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