# Arctic Sun Surface Temperature Management Device for Neuroprotection During Pregnancy—A Short Case Report and Review of the Literature

## TL;DR

A cooling device was used to manage a pregnant woman's brain swelling, but it led to a preterm stillbirth, highlighting the need for caution and more research.

## Contribution

This case report explores the use of a surface cooling device in pregnancy, highlighting its potential risks and the need for further investigation.

## Key findings

- The Arctic Sun system maintained normothermia in a pregnant ICU patient without immediate adverse effects.
- The patient experienced a spontaneous preterm delivery of a stillborn fetus during treatment.
- The case underscores the need for caution and evidence-based guidelines for TTM in pregnant patients.

## Abstract

Targeted temperature management (TTM), particularly the avoidance of hyperpyrexia, is a cornerstone of intensive care, especially in conditions such as cerebral edema and increased intracranial pressure. Management becomes more complex in pregnancy, where maternal neuroprotection must be weighed against fetal safety. Both invasive and noninvasive methods for temperature control have been described, but evidence regarding their safety in pregnancy remains limited. We present the case of a 24-year-old pregnant woman admitted to the ICU with cerebral edema due to subdural empyema. The Arctic Sun surface cooling system was employed for fever control, with continuous maternal and fetal monitoring. The system effectively maintained normothermia without immediate adverse effects on either the mother or the fetus. However, on the third day of its use, the patient experienced a spontaneous preterm delivery of a stillborn fetus. Although a causal link between surface cooling and preterm labor cannot be established from this single case, the event underscores the need for caution and further investigation. This case highlights both the feasibility and the uncertainties of using advanced TTM devices in critically ill pregnant patients. It emphasizes the importance of multidisciplinary monitoring and the urgent need for evidence-based guidelines to balance maternal benefits with fetal safety.