The RhinoChill intranasal cooling system for reducing temperature after cardiac arrest

Search strategy

The search strategy was peer reviewed by an independent information specialist. The following databases were searched:

MEDLINE, MEDLINE in Process and Embase were searched using the OvidSP interface. All other databases were searched using the Cochrane Library interface. The search strategies for each of the 6 literature databases are presented below (A1 to A6).

A1: Source: MEDLINE In-Process & Other Non-indexed Citations and Ovid MEDLINE 1946 to Present. Search date: 22/10/13

1 exp Heart Arrest/ 33667 

2 exp Cardiopulmonary Resuscitation/ 11375 

3 ((heart* or cardiac* or cardiopulmonary* or cardio-pulmonar* or circulat*) adj5 arrest*).ti,ab. 29159 

4 ((heart* or cardiac* or cardiopulmonary* or cardio-pulmonar* or circulat*) adj5 (resuscita* or life support*)).ti,ab. 13961 

5 (sudden cardiac death* or SCD or SCA).ti,ab. 18686 

6 or/1-5 71829 

7 exp Cerebrovascular Disorders/ 275909 

8 (stroke or strokes or poststroke or poststrokes or cerebrovasc* or cerebro-vasc* or brain vasc* or cerebral vasc* or cva* or apoplexy* or SAH).ti,ab. 196056 

9 ((brain* or cerebr* or cerebell* or cortical or vertebrobasilar or hemisphere* or intracran* or intra-cran* or intracerebral or infratentorial or infra-tentorial or supratentorial or supra-tentorial or MCA or anterior circulation or posterior circulation or basal gangli*) adj5 (ischemi* or ischaemi* or infarct* or thrombo* or emboli* or occlus* or hypox* or vasospasm*)).ti,ab. 88408 

10 ((brain* or cerebr* or cerebell* or intracerebral or intracran* or intra-cran* or parenchymal or intraventricular or intra-ventricular or infratentorial or infra-tentorial or supratentorial or supra-tentorial or basal gangli* or subarachnoid) adj5 (haemorrhage* or hemorrhage* or haematoma* or hematoma* or bleed*)).ti,ab. 49562 

11 or/7-10 394509 

12 exp Craniocerebral Trauma/ 120439 

13 Brain Edema/ 12285 

14 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemisphere*) adj5 (injur* or trauma* or damage* or wound* or fracture* or contusion*)).ti,ab. 114180 

15 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemisphere*) adj5 (edem* or oedem* or swell*)).ti,ab. 14905 

16 (TBI or diffuse axonal injur*).ti,ab. 13767 

17 or/12-16 202435 

18 6 or 11 or 17 610402 

19 Hypothermia, Induced/ 16514 

20 Cryotherapy/ 3715 

21 Hypothermia/ 8604 

22 Cold Temperature/ 42038 

23 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherapy* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*).ti,ab. 164801 

24 ((low or lower* or reduc*) adj5 temperature*).ti,ab. 65380 

25 or/19-24 236682 

26 Administration, Intranasal/ 11505 

27 exp Nose/ 71246 

28 exp Nasopharynx/ 9445 

29 (nasal* or intranasal* or transnasal* or nasopharyn* or naso-pharyn* or rhinopharyn* or rhino-pharyn* or nose or noses or nostril*).ti,ab. 143015 

30 or/26-29 181289 

31 18 and 25 and 30 251 

32 (rhinochill* or rhino chill* or benechill* or bene chill*).ti,ab. 8 

33 ((nasal* or intranasal* or transnasal* or nasopharyn* or naso-pharyn* or rhinopharyn* or rhino-pharyn* or nose or noses or nostril*) adj5 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherapy* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*)).ti,ab. 588 

34 or/31-33 765 

35 exp animals/ not humans/ 4050087 

36 34 not 35 648 

37 limit 36 to (english language and yr="2008 -Current") 129

A.2: Source: Database of Abstracts of Reviews of Effectiveness (DARE) - Issue 3 of 4, Jul 2013. Search date: 23/10/13

#1 MeSH descriptor: [Heart Arrest] explode all trees 1080

#2 MeSH descriptor: [Cardiopulmonary Resuscitation] explode all trees 525

#3 ((heart* or cardiac* or cardiopulmonar* or cardio-pulmonar* or circulat*) near/5 arrest*) 2040

#4 ((heart* or cardiac* or cardiopulmonar* or cardio-pulmonar* or circulat*) near/5 (resuscita* or life support*)) 1062

#5 (sudden next cardiac next death* or SCD or SCA) 820

#6 #1 or #2 or #3 or #4 or #5  3451

#7 MeSH descriptor: [Cerebrovascular Disorders] explode all trees 8578

#8 (stroke or strokes or poststroke or poststrokes or cerebrovasc* or cerebro-vasc* or brain next vasc* or cerebral next vasc* or cva* or apoplex* or SAH) 31807

#9 ((brain* or cerebr* or cerebell* or cortical or vertebrobasilar or hemispher* or intracran* or intra-cran* or intracerebral or infratentorial or infra-tentorial or supratentorial or supra-tentorial or MCA or anterior next circulation or posterior next circulation or basal next gangli*) near/5 (ischemi* or ischaemi* or infarct* or thrombo* or emboli* or occlus* or hypox* or vasospasm*)) 5794

#10 ((brain* or cerebr* or cerebell* or intracerebral or intracran* or intra-cran* or parenchymal or intraventricular or intra-ventricular or infratentorial or infra-tentorial or supratentorial or supra-tentorial or basal gangli* or subarachnoid) near/5 (haemorrhage* or hemorrhage* or haematoma* or hematoma* or bleed*)) 4056

#11 #7 or #8 or #9 or #10  35341

#12 MeSH descriptor: [Craniocerebral Trauma] explode all trees 1740

#13 MeSH descriptor: [Brain Edema] this term only 124

#14 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemispher*) near/5 (injur* or trauma* or damag* or wound* or fracture* or contusion*)) 4257

#15 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemispher*) near/5 (edem* or oedem* or swell*)) 483

#16 (TBI or diffuse next axonal next injur*) 592

#17 #12 or #13 or #14 or #15 or #16  5226

#18 #6 or #11 or #17  41518

#19 MeSH descriptor: [Hypothermia, Induced] this term only 674

#20 MeSH descriptor: [Cryotherapy] this term only 415

#21 MeSH descriptor: [Hypothermia] this term only 301

#22 MeSH descriptor: [Cold Temperature] this term only 1030

#23 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherap* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*) 9773

#24 ((low or lower* or reduc*) near/5 temperature*) 979

#25 #19 or #20 or #21 or #22 or #23 or #24  10302

#26 #18 and #25  1463

#27 (rhinochill* or rhino next chill* or benechill* or bene next chill*) 6

#28 ((nasal* or intranasal* or transnasal* or nasopharyn* or naso-pharyn* or rhinopharyn* or rhino-pharyn* or nose or noses or nostril*) near/5 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherap* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*)) 210

#29 #26 or #27 or #28 from 2008 to 2013, in Other Reviews 32

A.3: Source: Health Technology Assessment database (HTA) - Issue 3 of 4 Jul 2013. Search date: 23/10/13

#1 MeSH descriptor: [Heart Arrest] explode all trees 1080

#2 MeSH descriptor: [Cardiopulmonary Resuscitation] explode all trees 525

#3 ((heart* or cardiac* or cardiopulmonar* or cardio-pulmonar* or circulat*) near/5 arrest*) 2040

#4 ((heart* or cardiac* or cardiopulmonar* or cardio-pulmonar* or circulat*) near/5 (resuscita* or life support*)) 1062

#5 (sudden next cardiac next death* or SCD or SCA) 820

#6 #1 or #2 or #3 or #4 or #5  3451

#7 MeSH descriptor: [Cerebrovascular Disorders] explode all trees 8578

#8 (stroke or strokes or poststroke or poststrokes or cerebrovasc* or cerebro-vasc* or brain next vasc* or cerebral next vasc* or cva* or apoplex* or SAH) 31807

#9 ((brain* or cerebr* or cerebell* or cortical or vertebrobasilar or hemispher* or intracran* or intra-cran* or intracerebral or infratentorial or infra-tentorial or supratentorial or supra-tentorial or MCA or anterior next circulation or posterior next circulation or basal next gangli*) near/5 (ischemi* or ischaemi* or infarct* or thrombo* or emboli* or occlus* or hypox* or vasospasm*)) 5794

#10 ((brain* or cerebr* or cerebell* or intracerebral or intracran* or intra-cran* or parenchymal or intraventricular or intra-ventricular or infratentorial or infra-tentorial or supratentorial or supra-tentorial or basal gangli* or subarachnoid) near/5 (haemorrhage* or hemorrhage* or haematoma* or hematoma* or bleed*)) 4056

#11 #7 or #8 or #9 or #10  35341

#12 MeSH descriptor: [Craniocerebral Trauma] explode all trees 1740

#13 MeSH descriptor: [Brain Edema] this term only 124

#14 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemispher*) near/5 (injur* or trauma* or damag* or wound* or fracture* or contusion*)) 4257

#15 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemispher*) near/5 (edem* or oedem* or swell*)) 483

#16 (TBI or diffuse next axonal next injur*) 592

#17 #12 or #13 or #14 or #15 or #16  5226

#18 #6 or #11 or #17  41518

#19 MeSH descriptor: [Hypothermia, Induced] this term only 674

#20 MeSH descriptor: [Cryotherapy] this term only 415

#21 MeSH descriptor: [Hypothermia] this term only 301

#22 MeSH descriptor: [Cold Temperature] this term only 1030

#23 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherap* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*) 9773

#24 ((low or lower* or reduc*) near/5 temperature*) 979

#25 #19 or #20 or #21 or #22 or #23 or #24  10302

#26 #18 and #25  1463

#27 (rhinochill* or rhino next chill* or benechill* or bene next chill*) 6

#28 ((nasal* or intranasal* or transnasal* or nasopharyn* or naso-pharyn* or rhinopharyn* or rhino-pharyn* or nose or noses or nostril*) near/5 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherap* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*)) 210

#29 #26 or #27 or #28 from 2008 to 2013, in Technology Assessments 13

A.4: Source: Cochrane Central Register of Controlled Trials (CENTRAL) - Issue 3 of 4 Jul 2013. Search date: 22/10/13

#1 MeSH descriptor: [Heart Arrest] explode all trees 1080

#2 MeSH descriptor: [Cardiopulmonary Resuscitation] explode all trees 525

#3 ((heart* or cardiac* or cardiopulmonar* or cardio-pulmonar* or circulat*) near/5 arrest*) 2040

#4 ((heart* or cardiac* or cardiopulmonar* or cardio-pulmonar* or circulat*) near/5 (resuscita* or life support*)) 1062

#5 (sudden next cardiac next death* or SCD or SCA) 820

#6 #1 or #2 or #3 or #4 or #5  3451

#7 MeSH descriptor: [Cerebrovascular Disorders] explode all trees 8578

#8 (stroke or strokes or poststroke or poststrokes or cerebrovasc* or cerebro-vasc* or brain next vasc* or cerebral next vasc* or cva* or apoplex* or SAH) 31807

#9 ((brain* or cerebr* or cerebell* or cortical or vertebrobasilar or hemispher* or intracran* or intra-cran* or intracerebral or infratentorial or infra-tentorial or supratentorial or supra-tentorial or MCA or anterior next circulation or posterior next circulation or basal next gangli*) near/5 (ischemi* or ischaemi* or infarct* or thrombo* or emboli* or occlus* or hypox* or vasospasm*)) 5794

#10 ((brain* or cerebr* or cerebell* or intracerebral or intracran* or intra-cran* or parenchymal or intraventricular or intra-ventricular or infratentorial or infra-tentorial or supratentorial or supra-tentorial or basal gangli* or subarachnoid) near/5 (haemorrhage* or hemorrhage* or haematoma* or hematoma* or bleed*)) 4056

#11 #7 or #8 or #9 or #10  35341

#12 MeSH descriptor: [Craniocerebral Trauma] explode all trees 1740

#13 MeSH descriptor: [Brain Edema] this term only 124

#14 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemispher*) near/5 (injur* or trauma* or damag* or wound* or fracture* or contusion*)) 4257

#15 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemispher*) near/5 (edem* or oedem* or swell*)) 483

#16 (TBI or diffuse next axonal next injur*) 592

#17 #12 or #13 or #14 or #15 or #16  5226

#18 #6 or #11 or #17  41518

#19 MeSH descriptor: [Hypothermia, Induced] this term only 674

#20 MeSH descriptor: [Cryotherapy] this term only 415

#21 MeSH descriptor: [Hypothermia] this term only 301

#22 MeSH descriptor: [Cold Temperature] this term only 1030

#23 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherap* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*) 9773

#24 ((low or lower* or reduc*) near/5 temperature*) 979

#25 #19 or #20 or #21 or #22 or #23 or #24  10302

#26 MeSH descriptor: [Administration, Intranasal] this term only 1941

#27 MeSH descriptor: [Nose] explode all trees 1944

#28 MeSH descriptor: [Nasopharynx] explode all trees 291

#29 (nasal* or intranasal* or transnasal* or nasopharyn* or naso-pharyn* or rhinopharyn* or rhino-pharyn* or nose or noses or nostril*) 13189

#30 #26 or #27 or #28 or #29  13474

#31 #18 and #25 and #30  143

#32 (rhinochill* or rhino next chill* or benechill* or bene next chill*) 6

#33 ((nasal* or intranasal* or transnasal* or nasopharyn* or naso-pharyn* or rhinopharyn* or rhino-pharyn* or nose or noses or nostril*) near/5 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherap* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*)) 210

#34 #31 or #32 or #33 from 2008 to 2013, in Trials 19

A.5: Source: Cochrane Database of Systematic Reviews (CDSR). Search date: 23/10/13

#1 MeSH descriptor: [Heart Arrest] explode all trees 1080

#2 MeSH descriptor: [Cardiopulmonary Resuscitation] explode all trees 525

#3 ((heart* or cardiac* or cardiopulmonar* or cardio-pulmonar* or circulat*) near/5 arrest*):ti,ab,kw 1733

#4 ((heart* or cardiac* or cardiopulmonar* or cardio-pulmonar* or circulat*) near/5 (resuscita* or life support*)):ti,ab,kw 943

#5 (sudden next cardiac next death* or SCD or SCA):ti,ab,kw 653

#6 #1 or #2 or #3 or #4 or #5  2987

#7 MeSH descriptor: [Cerebrovascular Disorders] explode all trees 8578

#8 (stroke or strokes or poststroke or poststrokes or cerebrovasc* or cerebro-vasc* or brain next vasc* or cerebral next vasc* or cva* or apoplex* or SAH):ti,ab,kw 22589

#9 ((brain* or cerebr* or cerebell* or cortical or vertebrobasilar or hemispher* or intracran* or intra-cran* or intracerebral or infratentorial or infra-tentorial or supratentorial or supra-tentorial or MCA or anterior next circulation or posterior next circulation or basal next gangli*) near/5 (ischemi* or ischaemi* or infarct* or thrombo* or emboli* or occlus* or hypox* or vasospasm*)):ti,ab,kw 4919

#10 ((brain* or cerebr* or cerebell* or intracerebral or intracran* or intra-cran* or parenchymal or intraventricular or intra-ventricular or infratentorial or infra-tentorial or supratentorial or supra-tentorial or basal gangli* or subarachnoid) near/5 (haemorrhage* or hemorrhage* or haematoma* or hematoma* or bleed*)):ti,ab,kw 3177

#11 #7 or #8 or #9 or #10  27884

#12 MeSH descriptor: [Craniocerebral Trauma] explode all trees 1740

#13 MeSH descriptor: [Brain Edema] this term only 124

#14 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemispher*) near/5 (injur* or trauma* or damag* or wound* or fracture* or contusion*)):ti,ab,kw 3372

#15 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemispher*) near/5 (edem* or oedem* or swell*)):ti,ab,kw 343

#16 (TBI or diffuse next axonal next injur*):ti,ab,kw 501

#17 #12 or #13 or #14 or #15 or #16  4252

#18 #6 or #11 or #17  33634

#19 MeSH descriptor: [Hypothermia, Induced] this term only 674

#20 MeSH descriptor: [Cryotherapy] this term only 415

#21 MeSH descriptor: [Hypothermia] this term only 301

#22 MeSH descriptor: [Cold Temperature] this term only 1030

#23 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherap* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*):ti,ab,kw 8043

#24 ((low or lower* or reduc*) near/5 temperature*):ti,ab,kw 869

#25 #19 or #20 or #21 or #22 or #23 or #24  8528

#26 #18 and #25  976

#27 (rhinochill* or rhino next chill* or benechill* or bene next chill*):ti,ab,kw 6

#28 ((nasal* or intranasal* or transnasal* or nasopharyn* or naso-pharyn* or rhinopharyn* or rhino-pharyn* or nose or noses or nostril*) near/5 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherap* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*)):ti,ab,kw 176

#29 #26 or #27 or #28 from 2008 to 2013, in Cochrane Reviews (Reviews and Protocols) 34

A.6: Source: Embase 1974 to 2013 October 22. Search date: 23/10/13

1 exp heart arrest/ 46245 

2 resuscitation/ 65875 

3 ((heart* or cardiac* or cardiopulmonary* or cardio-pulmonar* or circulat*) adj5 arrest*).ti,ab. 38150 

4 ((heart* or cardiac* or cardiopulmonary* or cardio-pulmonar* or circulat*) adj5 (resuscita* or life support*)).ti,ab. 17709 

5 (sudden cardiac death* or SCD or SCA).ti,ab. 25836 

6 or/1-5 131314 

7 exp cerebrovascular disease/ 362327 

8 stroke/ 127432 

9 stroke patient/ 8900 

10 stroke unit/ 1615 

11 (stroke or strokes or poststroke or poststrokes or cerebrovasc* or cerebro-vasc* or brain vasc* or cerebral vasc* or cva* or apoplexy* or SAH).ti,ab. 263173 

12 ((brain* or cerebr* or cerebell* or cortical or vertebrobasilar or hemisphere* or intracran* or intra-cran* or intracerebral or infratentorial or infra-tentorial or supratentorial or supra-tentorial or MCA or anterior circulation or posterior circulation or basal gangli*) adj5 (ischemi* or ischaemic* or infarct* or thrombo* or emboli* or occlus* or hypox* or vasospasm*)).ti,ab. 115208 

13 ((brain* or cerebr* or cerebell* or intracerebral or intracran* or intra-cran* or parenchymal or intraventricular or intra-ventricular or infratentorial or infra-tentorial or supratentorial or supra-tentorial or basal gangli* or subarachnoid) adj5 (haemorrhage* or haemorrhage* or haematoma* or hematoma* or bleed*)).ti,ab. 65266 

14 or/7-13 543723 

15 exp head injury/ 214002 

16 coma/ 22248 

17 traumatic epilepsy/ 1334 

18 brain edema/ 22925 

19 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemisphere*) adj5 (injur* or trauma* or damage* or wound* or fracture* or contusion*)).ti,ab. 144804 

20 ((head or heads or forehead* or crani* or intracrani* or intercrani* or cerebr* or intracerebr* or intercerebr* or capitis or brain* or forebrain* or skull* or hemisphere*) adj5 (edem* or oedema* or swell*)).ti,ab. 19204 

21 (TBI or diffuse axonal injur*).ti,ab. 19531 

22 or/15-21 314018 

23 6 or 14 or 22 902350 

24 induced hypothermia/ 8670 

25 profound induced hypothermia/ 267 

26 cryotherapy/ 12102 

27 hypothermia/ 25553 

28 low temperature/ 10690 

29 low temperature procedures/ 1744 

30 cold treatment/ 381 

31 cooling/ 10724 

32 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherapy* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*).ti,ab. 198446 

33 ((low or lower* or reduc*) adj5 temperature*).ti,ab. 64407 

34 or/24-33 269806 

35 intranasal drug administration/ 11550 

36 exp nose/ 51549 

37 exp nasopharynx/ 10303 

38 nasopharynx airway/ 35 

39 (nasal* or intranasal* or transnasal* or nasopharyn* or naso-pharyn* or rhinopharyn* or rhino-pharyn* or nose or noses or nostril*).ti,ab. 170749 

40 or/35-39 193421 

41 23 and 34 and 40 356 

42 (rhinochill* or rhino chill* or benechill* or bene chill*).af. 31 

43 ((nasal* or intranasal* or transnasal* or nasopharyn* or naso-pharyn* or rhinopharyn* or rhino-pharyn* or nose or noses or nostril*) adj5 (cool* or chill* or cold* or hypotherm* or hypo-therm* or cryotherapy* or cryo-therap* or cryotreat* or cryo-treat* or cryogen* or cryo-gen* or cryotherm* or cryo-therm*)).ti,ab. 714 

44 or/41-43 959 

45 (animal experiment/ or animal model/ or animal tissue/ or nonhuman/) not human/ 3680046 

46 44 not 45 857 

47 limit 46 to (english language and yr="2008 -Current")

Evidence selection

Initial scoping work on the topic, with NICE, informed the inclusion and exclusion criteria for the final evidence selection. The BeneChill website indicated that the stroke and traumatic brain injury applications of the RhinoChill system are still in clinical trials. Search terms for these clinical applications were included in the search strategy and relevant papers, when retrieved, confirmed this understanding.

This first sift removed evidence based on the following exclusion criteria:

A total of 460 records were retrieved from the literature search. After removing duplicated records, 316 remained. An initial 199 records were excluded as being animal studies, studies on children, the wrong population or irrelevant. A total of 117 were considered in more detail and a further 92 records were excluded, comprising: 29 conference abstracts, 2 without English translation, 1 animal study, 17 with an alternative population, 19 in the wrong clinical setting, 7 using alternative devices or technologies, 6 not relevant to cooling, and 10 were not original research (5 reviews, 4 letters/editorials, 1 study protocol), plus 1 duplicate. Full articles were ordered for the remaining 25 records, with 22 successfully retrieved within the timeframe of production of this briefing.

A second sift of the evidence included relevant primary research addressing the use of the medical technology within the defined indication under review (cardiac arrest). The conventional evidence hierarchy applies and the best available evidence was selected for inclusion within the evidence tables and for critical appraisal.

Included studies in second sift:

During the second sift, 19 records were excluded for the following reasons: 6 did not describe intranasal cooling or the RhinoChill device, 3 pooled data and therefore results were not specific to intranasal cooling, RhinoChill or a cardiac arrest population, 9 were not original research (5 review articles, 2 letters to the editor, 1 editorial, 1 study protocol) and 1 was a non-English language study.

This left 3 articles on the cardiac arrest application of RhinoChill for inclusion in the evidence tables and critical appraisal (1 randomised controlled trial, 1 case series and 1 case report, tables 1 to 3 respectively). The HTA systematic review (Harris et al. 2012) was used to inform the narrative in this briefing for the clinical application of RhinoChill to stroke and traumatic brain injury.