Re: 'Feasibility of a Miniature Esophageal Heat Exchange Device for Rapid Therapeutic Cooling in Newborns: Preliminary Investigations in a Piglet Model' by Dingley et al. (Ther Hypothermia Temp Manag 2018;8:36-44)

摘要

We read with interest the well-done work by Dingley et al. (2017) for testing the efficacy of using an esophageal device to decrease and maintain core body temperature in a piglet model. We have seen growing clinical use of this approach in adults, with reports showing efficacy, safety, and cost savings (Goury et al, 2017; Hegazy et al, 2017; Khan et al, 2017). Multiple reports show the lack of evidence of esophageal injury either en-doscopically or on histopathology, even after prolonged durations of use (Kulstad et al, 2013, 2015; Goury et al, 2017; Markota et al, 2017; Naiman et al, 2017; Schroeder et al, 2017). Since the gastrointestinal tract can undergo profound growth, morphological changes, and functional maturation in the initial hours to days of life, and the esophagus can show an accelerated cell proliferation in the epithelium and an increased production and accumulation of mucus in the glands (Xu, 1996), might there be unique physiological responses to temperature in the neonatal piglet model not seen in later stages of development?