Core warming of coronavirus disease 2019 (COVID-19) patients undergoing mechanical ventilation: protocol for a randomized controlled pilot study

Nathaniel Bonfanti; Emily Gundert; Kristina Goff; Anne Drewry; Roger Bedimo; Erik Kulstad

Core temperature control and warming will be performed with a commercially available esophageal heat exchange device (ensoETM, Attune Medical, Chicago, IL). This device is currently used world-wide for various patient temperature management goals, including postcardiac arrest therapeutic hypothermia, [44] [45] [46] [47] warming of burn patients, [48] warming general surgical patients, [49] cooling traumatic brain injury, [50] cooling heat stroke, [51] and the treatment of central fever. [52, 53] The device is a multi-chambered silicone tube placed in the esophagus and connected to a heat exchanger to provide heat transfer to or from a patient (video available at https://vimeo.com/306506411). Modulation and control of the patient's temperature is achieved by adjusting setpoint on the external heat exchanger, which in turn controls the circulating water temperature. Two lumens of the device connect to the external heat exchanger, while a third central lumen provides stomach access for gastric decompression or tube feeding. It is a single-use, disposable, non-implantable device with an intended duration of use of 72 hours or less.