Therapeutic hypothermia companies have largely been disappointing for investors who poured in -- and lost -- fortunes investing in promising cooling technologies. But while many first-generation start-ups no longer exist, the technologies they developed live on within the large corporations that paid pennies on the dollars to acquire them. Although the pioneers in the field failed to meet their objectives, there is reason for hope. Their corporate acquirers have continued to move the technology down the field. The end zone may not be in sight, yet, but advancement is slow and steady. Meanwhile, medical societies including the American Heart Association have issued guidelines on how hospitals should employ therapeutic hypothermia in treating patients. Similarly, some decision makers - including the City of New York - are requiring patients be taken to facilities that offer cooling treatments, giving the field the legitimacy it lacked for so long. Finally, innovation is beginning to take root again as new start-ups develop a next generation of therapeutic hypothermia devices. Taken together, these developments suggest that patient temperature management may arrive someday soon.
By most clinical measures, therapeutic hypothermia should work.
Lowering the body's temperature at a time of physical stress or
injury such as cardiac arrest or stroke helps slow the multiple
mechanisms by which ischemia and reperfusion cause injury. These
complex metabolic processes have often stumped drug developers
trying to influence specific molecular pathways, but hypothermia
broadly slows down metabolic activity, staving off damage on many
fronts. ( See Exhibit 1.)
Yet the area is short of success stories. Companies that set out to realize the field's promise back in the late 1990s – Alsius Medical Corp., Radiant Medical Inc. (both...
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