Devices and Methods to Obviate the Risk of Ischemic Injury during Cryotherapy

消除冷冻治疗期间缺血性损伤风险的装置和方法

• 批准号: 8836537
• 负责人: Robert Matthew Brothers
• 金额: $ 35.63万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-15 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8836537
• 关键词: Adverse effects; Affect; Amaze; Area; Biological Availability; Blood Circulation; Blood Vessels; Blood flow; Cardiovascular system; Cold Therapy; Communities; Cutaneous; Data; Dependency; Depressed mood; Device Designs; Devices; Dose; Engineering; Equilibrium; Excision; Exposure to; Goals; Guidelines; Health; Heating; Hour; Human; Ice; Inflammation; Injury; Interdisciplinary Study; Intervention; Ischemia; Maps; Measures; Mediator of activation protein; Mental Depression; Metabolism; Methods; Microdialysis; Molecular; Monitor; Necrosis; Nerve; Neuropathy; Optics; Orthopedic Surgery procedures; Outcome; Pain; Physiological; Physiology; Procedures; Process; Refrigeration; Rehabilitation therapy; Research; Risk; Risk Factors; Series; Signal Transduction; Site; Skin; Skin Temperature; Solutions; Source; Sports Medicine; Swelling; Techniques; Technology; Temperature; Testing; Therapeutic; Time; Tissues; Translating; United States; Up-Regulation; Water; Work; base; blood perfusion; cold injury; design; effective therapy; high risk; human subject; injured; innovation; insight; instrumentation; new technology; next generation; novel; prototype; research study; response; soft tissue; solid state; thermal stress; tissue oxygenation; tissue trauma; vasoactive agent; vasoconstriction

DESCRIPTION (provided by applicant): This proposal presents an innovative and effective solution to the problem of ischemia derived injuries to the skin and nerves as a consequence of applied cold therapy. Cooling is commonly used after orthopedic surgery and in sports medicine to reduce pain, swelling, inflammation, and metabolism. Although cryotherapy has been widely practiced for centuries, and its benefits are recognized intuitively even within the lay community, it is rather amazing that there is no definitive understanding of the risk factors associated with ts use. These risks are significant as evidenced by an annual occurrence of some 1,500 cases of cryotherapy injury involving extensive tissue necrosis and/or severe neuropathy. More than 120 preliminary studies have documented that even brief exposures to circulating ice water cause a deep state of ischemia that persists for hours after the removal of cold. Our studies have also documented the alteration of local availability and action of vasoactive molecules in conjunction with creating and sustaining the ischemic state. We have invented a proprietary technology that includes special devices and application methods that deliver cryotherapy with all of its benefits while also greatly lowering the risk of ischemia induced injury. The technology works by periodically stimulating blood flow in affected areas during the application of cryotherapy. We also apply the refrigeration source directly to the treatment area via solid state cooling technology with greatly increased thermal efficiency and control. We have assembled an exceptional interdisciplinary research team with expertise in human thermal physiology, bioheat transfer engineering, device design, and cardiovascular flow control mechanisms. The research plan will consist of three aims to: (a) characterize the problem: map the depression of skin blood perfusion as a function of the temperature and exposure time to cryotherapy, (b) define the mechanism of action: apply microdialysis technology to identify and measure the action of candidate vasoactive agents that govern the vascular response to cryotherapy, and (c) design, implement, and verify the solution: build and test prototype devices to stimulate blood flow in skin during cryotherapy and measure the effect on ischemia induction. We have already demonstrated the efficacy of multiple modes of stimulating blood flow that can be combined with cryotherapy. We believe that this technology will have a transformative benefit to the practice of cryotherapy and will enable its benefits to be realized with a greatly reduced risk of collateral injury in skin and nerves.

描述（由申请人提供）：该提案为缺血性造成的缺血性损伤问题提供了一种创新有效的解决方案，这是由于应用冷疗法而导致的。冷却在骨科手术和运动医学后通常用于减轻疼痛，肿胀，炎症和代谢。尽管冷冻疗法已被广泛实践了几个世纪，并且它的好处即使在外行社区内也被视觉，但 令人惊讶的是，对与TS使用相关的风险因素没有明确的了解。这些风险很明显，因为每年发生约1,500例冷冻疗法损伤涉及广泛的组织坏死和/或严重的神经病。超过120项初步研究表明，即使是短暂的循环冰水的暴露也会引起深层缺血状态，在寒冷去除后数小时持续了数小时。我们的研究还记录了血管活性分子的局部可用性和作用的改变，并结合创建和维持缺血状态。我们发明了一项专有技术，其中包括特殊的设备和应用方法，可提供冷冻疗法以及其所有好处，同时也大大降低了缺血诱发的损伤的风险。该技术通过在使用冷冻疗法期间定期刺激受影响地区的血流来起作用。我们还通过固态冷却技术直接将制冷源直接应用于治疗区域，并具有大大提高的热效率和控制。我们已经组建了一个杰出的跨学科研究团队，该团队在人类热生理学，生物学转移工程，设备设计和心血管流动控制机制方面具有专业知识。 The research plan will consist of three aims to: (a) characterize the problem: map the depression of skin blood perfusion as a function of the temperature and exposure time to cryotherapy, (b) define the mechanism of action: apply microdialysis technology to identify and measure the action of candidate vasoactive agents that govern the vascular response to cryotherapy, and (c) design, implement, and verify the solution: build and test prototype devices to stimulate blood flow in skin在冷冻疗法期间并测量对缺血诱导的影响。我们已经证明了可以与冷冻疗法结合的多种刺激血流模式的功效。 我们认为，这项技术将对实践带来变革性的好处 冷冻疗法，并可以通过大大降低皮肤和神经附带损伤的风险来实现其益处。