Burning issues: Early cooling of the brain after resuscitation using burn dressings. A proof of concept observation

Abstract

Early cooling of resuscitated patients improves neurological outcome. Out-of hospital initiation of cooling is uncommon however for mainly practical reasons. Using burn dressings in the out-of-hospital care could initiate brain cooling in an early stage and therefore be of value; the method is easily adaptable by ambulance crews. The influence of burn dressings on brain temperature is however unknown. We determined tympanic temperature changes as proxy for brain temperature in healthy volunteers after the application of cooling dressings to face and neck as a proof of concept study. In 10 healthy human volunteers tympanic temperatures were measured in 30s intervals before, during and after the application of burn-dressings, special trauma burn-care dressings that are designed for the acute treatment of skin burns (Burnshield emergency burn care sterile trauma burn dressings, Burnshield Ltd., Wadefield, South Africa) for the duration of 20min for each episode. In all study subjects the tympanic temperature was significantly lowered after 20min of the application of the burnshields. The mean difference between baseline and 2nd half of the exposure period was 0.43 degrees C (p<0.0001), ranging from 0.10 to 1.18 degrees C. Burn dressings could be of value in the early initiation of brain cooling in resuscitated patients. This study warrants further research to the effect of burnshield dressings on neurological activity and the effect on outcome after resuscitation.