# BREEZE: New Ventricular Direct Cooling Stylet to Mitigate Secondary Brain Injury

> **NIH NIH R21** · DUKE UNIVERSITY · 2022 · $442,750

## Abstract

ABSTRACT
Millions of people worldwide suffer annually from severe traumatic brain injury, stroke, status epilepticus and
anoxia after cardiac arrest. These brain insults lead to high mortality, morbidity and disability unless rapidly and
properly treated. Rapid cooling can significantly mitigate brain injuries by notably reducing swelling, inflammation,
metabolism, and oxygen consumption ultimately preserving neurological function and enhancing recovery.
Unfortunately, current hypothermic intervention requires prolonged systemic body cooling and suboptimal
rewarming. This limitation results in healthy organ dysfunction and diminishes the benefits of reduced brain
temperature. Selective brain cooling through external head refrigeration shows some promises, but cooling is
limited to the brain surface. Other proposed selective brain cooling methods rely on inconvenient, expensive,
and potentially dangerous fluid circulation systems. Therefore, an effective, safe, convenient, and affordable
device to rapidly cool the injured brain without affecting negatively other organs remains an unmet crucial clinical
need.
To address this urgent need, we conceived a novel rapid cooling device for intracranial use or as a stylet for
widely used external ventricular drain (EVD) catheters. EVD catheters are used globally to monitor and reduce
intracranial pressure (ICP) in injured patients through cerebrospinal fluid (CSF) removal. Since CSF circulates
throughout the entire central nervous system, EVD catheters are an ideal conduit for brain and spinal cord
cooling. BREEZE (Brain Rapid Enthalpy Extractor with Zero-liquid Exchange) would conveniently replace current
stylets guiding EVD catheters into ventricles. Without interfering with CSF drainage, BREEZE could induce rapid
brain cooling a novel heat pipe- and ionic wind-based design. By exploiting capillary action and vapor expansion,
the heat-pipe transfers rapidly brain heat to an ionic wind fan, which dissipates it to colder external environments.
Our long-term objective is to improve neurological outcome of brain-injured patients by translating our low-cost
groundbreaking cooling technology into clinical practice. The rationale for our approach is that by integrating
heat-pipe, thermoelectric cooling, ionic wind, and adaptive control, we can provide effective selective cerebral
cooling to mitigate acute brain injury and improve patient recovery. Our underlying hypotheses are that our
cutting-edge cooling technology can be miniaturized into an EVD-compatible stylet (H1), adaptively controlled to
a user-defined thermal profile in biomimetic phantom (H2) and in non-human primates (H3). Thus, we propose
these specific aims: (SA1) Optimize BREEZE technology into a 1.5mm dia brain cooling intracranial/ventricular
stylet; (SA2) Build an adaptive brain-cooling algorithm for BREEZE using a bio-accurate model/phantom; (SA3)
Study initial feasibility of BREEZE selective/adaptive brain cooling in five non-human primates....

## Key facts

- **NIH application ID:** 10528204
- **Project number:** 1R21NS118670-01A1
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Paolo Francesco Maccarini
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $442,750
- **Award type:** 1
- **Project period:** 2022-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10528204

## Citation

> US National Institutes of Health, RePORTER application 10528204, BREEZE: New Ventricular Direct Cooling Stylet to Mitigate Secondary Brain Injury (1R21NS118670-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10528204. Licensed CC0.

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