Patent Publication Number: US-2020281284-A1

Title: Wearable, integrated cooling system

Description:
CLAIM OF PRIORITY 
     This application claims the benefit of priority under 35 U.S.C. § 119(e) to U.S. provisional application Ser. No. 62/606,667, filed Oct. 4, 2017, which is incorporated herein by reference in its entirety. 
    
    
     TECHNICAL FIELD 
     The technology described herein generally relates to a portable, wearable, cooling system for the avoidance and management of hyperthermia, and more particularly relates to a self-contained cooling system that is located within, or integrated into, a garment. 
     BACKGROUND 
     Exercise or activity-induced hyperthermia is a large-scale problem currently having few realistic solutions that can delay or prevent the onset of symptoms. The U.S. Center for Disease Control (CDC) tracked more than 3,000 hyperthermia-related deaths between 2009 and 2014, and concluded that the problem is not only growing, but that it is likely under-reported. 
     Several academic studies have confirmed that pre-cooling prior to strenuous activity can decrease core body temperature, delay the onset of hyperthermia, and improve a variety of performance-related metrics. Taken together, it is clear that pre-cooling improves both safety and performance of subjects in a setting where hyperthermia is a risk. As a result, there are a variety of commercial devices designed to be used prior to strenuous activity. These devices are generally vests that house chilled/frozen water, chilled gel, or phase change materials that can cool core temperatures. 
     It has been shown that the positive effects of pre-cooling are, however, generally lost after ˜30 minutes of activity. That is, body core temperatures of pre-cooled subjects converge back to the same as untreated controls after roughly 30-60 minutes of activity. Such studies therefore highlight the need for cooling during and throughout strenuous activity in order to prevent the onset of hyperthermia. To date, no device exists that is sufficiently lightweight and portable to be able to achieve that for most activities. 
     Cooling vests have been developed for a variety of applications, including the following: to be worn during activities subject to hyperthermia such as strenuous sports; work on outdoor construction projects; for use by firefighters; as well as in health-related situations such as for muscular dystrophy sufferers who are known to over-heat in daily activities. The way in which current cooling vests operate to cool subjects can be grouped into three categories:
         Passive cooling from pre-chilled inserts;   Semi-active cooling from evaporative or phase change materials; and   Active cooling with circulated refrigerants.       

     Existing insert-based options are not suitable for strenuous activities. The inserts have limited cooling capacity/duration, they are heavy, and they are generally poorly secured. Moreover, the inserts are typically large (such as-6 inches by 10 inches or larger in format, but can also be an inch thick and can weigh 7 pounds or more) and are therefore somewhat difficult to freeze in bulk, making them an inconvenient solution even in the industrial setting. Such devices tend to assume, on the one hand, that the device must provide its cooling effect for long periods of time, such as several hours, and therefore that the cooling inserts are necessarily bulky. 
     There are many different types of clothing or fabrics that can increase the body&#39;s natural evaporative cooling. While effective in some settings, the total capacity to remove heat from the body by passive means has significantly less impact than active cooling devices, and in high humidity environments in particular, evaporative cooling devices are insufficient. Perhaps most importantly, for many intensely physical activities (e.g., football, motorsports, the surgical setting, and emergency response workers), the safety gear worn by the subjects precludes the use of evaporative clothes that require access to the skin on one side and open air on the other. 
     Several active cooling devices have also been described previously. Typically, these devices circulate chilled water or air from large, non-portable, coolers or reservoirs, through plastic tubing, and into bladders that sit next to the wearer&#39;s skin. This approach is used not only for temperature control in hot environments, but also in rehabilitative medicine, and for devices designed to chill injured limbs or joints. None of these devices, however, has sufficient portability to facilitate use in sports or activities that require high levels of mobility. Specifically, these devices are heavy, are typically powered by a plug-in source of electricity, are connected to the wearers by long cumbersome tubes, and have heat exchangers mounted in bulky, inflexible garments. The large external cooling reservoirs typically hold several liters of ice and fluid and are therefore cumbersome. 
     Accordingly, there is an as yet unmet need for a cooling device that can be worn during intense physical activity which is not bulky and heavy, is not tethered to an external source of cooling fluid, and which nevertheless provides an active cooling function for prolonged periods of time. This is contrary to sideline systems or those meant for use before or after physical activity. 
     The discussion of the background herein is included to explain the context of the technology. This is not to be taken as an admission that any of the material referred to was published, known, or part of the common general knowledge as at the priority date of any of the claims found appended hereto. 
     Throughout the description and claims of the application the word “comprise” and variations thereof, such as “comprising” and “comprises”, is not intended to exclude other additives, components, integers or steps. 
     SUMMARY 
     A portable, wearable, cooling system for the avoidance and management of hyperthermia, and more particularly a self-contained cooling system that can be integrated into a garment. In one embodiment, the system comprises a removable cartridge having a cooling fluid therein, attached via tubing to a motorized pump driven by a power pack, such that the pump drives water from the cartridge through a circuit of tubes into a bladder that provides a cooling effect to the wearer. The cartridge, bladder, pump, and power pack sit in custom-fit pouches in the garment material. The cartridge can be removed and replaced when its cooling effect is diminished. The pump, power pack, and bladder can be removed before the garment is washed. In another embodiment, the bladder is not a removable piece but is an integrated portion of the garment, formed by creating a lumen in between two layers of bonded material. The lumen is connected at both its ends to the tubing that runs to the cartridge and pump. Cooling fluid is pumped through the lumen and thereby cools the wearer due to the proximity to the wearer&#39;s skin. 
     This disclosure addresses the need for a lightweight, portable, wearable cooling system. The terms “device” and “system” may find use interchangeably herein. Preferred embodiments of the system are extremely lightweight. For example, the typical weight for an entire system worn by a user according to descriptions herein is approximately 2 Kgs. It is to be understood that use of the terms “about” or “approximately” herein introduce a variation of +/−10% to the referenced value. 
     The system described herein achieves active cooling via a pump which causes a fluid to circulate and is battery powered and is therefore completely portable, and preferably wearable. 
     The system is integrated entirely into a user&#39;s clothing or equipment, in a further aspect of the portability of the device. Bladders and channels integrated into the clothing or an external piece of equipmentenable cooling water to reach desired areas such as the torso, injured joints, the arms, or the head/neck area depending upon the specific need and application. 
     The system uses small, replaceable (such as interchangeable), cartridges to store the cooling fluid. Liquid or gel-based cartridges (filled with ice, a slurry of ice/water, or other cooling liquids or gels) as used with the system typically have volumes less than 2 liters, such as 1 liter, 750 ml, 500 ml, or 250 ml, and gas cartridges (filled with compressed gases that cool when expanded) typically have volumes less than 250 ml. 
     Additionally, the system can be deployed with “smart” technology to provide a more comprehensive, integrated solution than is currently available in the art. For example, instruments or sensors that measure critical parameters such as surface or core temperature, heart rate, respiration rate, position, speed, levels of hydration or body chemistry, and the like can be built into the system. When data about such parameters is communicated to a system controller, aspects of cooling rate can be regulated automatically. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  shows a schematic view from the front of an exemplary football jersey having an integrated cooling system as described herein; 
         FIG. 2  shows components of an exemplary football jersey viewed from the back; 
         FIG. 3  shows the interior of an exemplary powerpack for a cooling football jersey; 
         FIG. 4  shows a method of inserting a cooling cartridge in a cooling football jersey; and 
         FIG. 5  shows a tube fitting for a football jersey cooling system. 
     
    
    
     DETAILED DESCRIPTION 
     The instant technology is directed to cooling devices that comprise one or more interchangeable or replaceable components, that incorporate an active cooling mechanism such as by circulating a coolant around an area adjacent to a user&#39;s skin, and that are portable or wearable. 
     Overview 
     Certain embodiments of the devices are comprised of four ( 4 ) components:
         A piece of clothing or equipment having one or more pouches for accepting one or more cooling bladders that are worn in contact with, or adjacent to, the user&#39;s body. A bladder is positioned such that it provides a source of cooling to one or more cooling surfaces and thereby transmits cooling effects through the cooling surfaces to the wearer&#39;s body.   One or more detachable, replaceable cartridges of cooling fluid(s), such as gases, gels, or solution from which the fluid(s) can be pumped into the cooling bladder(s).   A pump that can be driven by a self-contained power source integrated into the system in order to move the cooling fluid(s) through the system.   A number of pieces of tubing and/or one or more channels that connect the pump, cartridge(s), and bladder(s) to one another, thereby creating a circuit about which cooling fluid flows.       

     Certain other embodiments are comprised of three ( 3 ) components:
         A piece of clothing or equipment having one or more cooling panels (comprised of waterproof fabric) that are worn in contact with or adjacent to the user&#39;s body, and that is constructed in such a manner that cooling fluid(s), such as gases, gels, or solution can flow through a network of channels within the panels.   A pump that can be driven by a self-contained power source integrated into the system in order to move the gases, gels, or solution through the system.   A number of pieces of tubing and/or one or more channels that connect the pump, cartridge(s), and bladders to one another.       

     In any of the embodiments, additional instrumentation, control or communication devices such as sensors and transmitters can be integrated into the system, thereby allowing remote monitoring or controlling and feedback of data such as body temperature of the wearer, cooling fluid temperature, and cooling fluid flow-rate. In other embodiments, a support to hold the pump and cooling cartridge close and snugly against the wearer&#39;s body can also be included. Such a support can include one or more overwrap belts or tensioners, or skirts and belts within the clothing to provide additional holding force. 
     Because the technology herein does not rely upon or utilize an external source of coolant or an external pumping mechanism or external power, it is more portable and more compact than the active cooling systems of the prior art. 
     Clothing or Equipment 
     The technology described herein can be deployed within any item of clothing worn during activities such as, but not limited to: sports such as football, soccer, lacrosse, volleyball, tennis, baseball, running, and hockey; other outdoor recreation such as hiking, kayaking, or bicycling, heavy duty outdoor activity such as construction or landscaping, motor-sports, or in the healthcare setting. It is to be understood that, while the principal application of the technology is in outdoor activities, as typically practiced in daytime in full sun or in humid conditions, there may be indoor activities for which the technology is equally suited. For example, the technology could be deployed in sports such as track cycling, five-a-side soccer, handball, and basketball. 
     Consequently, items of clothing such as garments that can suitably accept the technology include but are not limited to: upper-wear such as jackets, sweaters, jerseys, vests, tunics, and shirts; lower-body wear such as shorts, belt-packs, sweat-pants, and leggings; and head gear such as helmets (e.g., as used in football, motor-racing, horse-riding, bicycling, or motor-cycling) and headbands. 
     In other embodiments, particularly those using post injury rehabilitative devices, the cooling panels, bladders, and/or channels can be integrated into joint braces or supports such as neoprene braces. 
     The technology may also be deployed within equipment that is worn or carried during sports or other outdoor activities. 
     Cooling Bladder 
     In certain embodiments, cooling of the wearer is achieved when the cooling fluid passes through a flat bladder that is positioned close to the wearer&#39;s skin, e.g., against the torso. The bladder remains in place during the activity in question but can be easily removed as and when the garment needs to be cleaned. The bladder is connected via tubing to a pump and one or more removeable cartridges of cooling fluid. 
     Integrated Cooling Surface 
     In the past, cooling garments have relied upon coiled plastic tubing, gel-filled inserts, or evaporative fabrics that are added into or onto garments such as T-shirts or vests. In a preferred embodiment of the present technology, a cooling surface is integrated directly into a garment by utilizing two layers of waterproof or water resistant fabric that are bonded together in a way that creates a lumen or channel between the layers through which chilled fluids, such as liquids or gases, pass without leaking. For example, the water-resistant fabric can be a Teflon-based layer such as is used in GoreTex™, and the fabric of the garment can be lycra. A material such as GoreTex is appropriate because it permits some passage of water vapor but does not permit water droplets to pass through it. A cooling surface of this form, integrated into the garment, is also referred to as a bladder herein but it is understood that it is not a removeable item. 
     This cooling mechanism is a new feature of a cooling garment because it is part of the garment itself, without a need for additional plastic tubing or an insertable bladder, or a separate pouch for accepting such a bladder. This mechanism will be considered surprising to those trained in the art who typically focus on the use of fabrics that wick moisture to accelerate evaporation. By contrast, in the technology herein, the fabric is essentially waterproof, and therefore offers very little relief to the wearer from evaporation through the cooling surface, but the cooling effect is provided by the proximity of circulating cooled fluid to the wearer&#39;s skin. 
     The cooling surface of this embodiment is connected to a pump and one or more interchangeable cartridges of cooling fluid via plastic tubing. As further described herein, the pump propels the cooling fluid round a circuit that includes the removeable cartridge and the cooling surface, through the tubes. 
     One important advantage of using the garment itself as the cooling surface is that there is direct contact between the cooling surface and the wearer&#39;s skin. Other systems that deploy cooling material in pouches transfer heat significantly less efficiently, because there is substantially more material or a greater number of layers of material between the cooling liquid and the wearer&#39;s skin. In addition to providing more efficient heat transfer, the cooling garments that embody the present technology are significantly lighter, more flexible, more comfortable, easier to clean, and more portable than other pouch-based systems, because they lack additional components such as external tubes or replaceable bladders. With fewer parts, joints, and plastic welds, the garments embodying the present technology are also more durable, and impact resistant than pouch-based systems. 
     Other embodiments of this wearable, portable cooling system can utilize cooling tubes or bladders, in combination with or independent of the cooling surfaces made with this bonded waterproof fabric strategy. 
     In some embodiments the two-layer cooling system is not a part of a garment but is manufactured as a panel of material, which itself can be inserted into a suitable pouch that has been sewn into the inner surface of the garment. 
     In any embodiment, the panel can be located in a specific area (rather than just be on a user&#39;s chest or back. For example, it could be just be positioned in the wearer&#39;s arm-pit where there is high bloodflow, or near a joint to reduce inflammation. Making it out of stretchable material means that it can be molded to the anatomy. 
     Whether manufactured as a panel or as an integral part of a garment, the lumen or lumens that comprise the cooling circuit can be attached to the remaining parts of the system by a pair of tube-stubs, one at each end of the channel. 
     The are several ways of manufacturing a garment having a circuit of cooling tubes defined by lumens within a waterproof layer and a fabric layer. For example, the two layers, such as a GoreTex™ membrane and lycra, can be squeezed together between a pair of drums; liquid adhesive poured in an appropriate pattern on the internal surface of one of the layers will create a network. An appropriate masking agent is preferably applied so that the glue does not spread and cause the entirety of the contact area between the two layers to become bonded. Suitable masking agents may include paper or wax, or any substance that can easily be removed from between the layers after the layers have been bonded together. 
     In other embodiments, the two layers of the garment can be attached to one another via sewing or some other manner of bonding, such as by application of heat. In one method, a plastic straw is placed between the two layers before they are bonded to one another in a configuration that corresponds to an appropriate cooling channel. Such a configuration could be a snaking up and down pattern. The two layers are bonded to one another in regions adjacent to where the plastic straw is placed. The plastic straw can be withdrawn from within the two layers after the bond is set and thereby reveal a continuous lumen defined purely by the two layers of material. 
     An alternative method of manufacture is to spray the adhesive on using a printing (e.g., inkjet type) method. 
     In alternative embodiments, aspects of additive manufacturing (also referred to as “3D-printing”) can be utilized to create the laminate structure. 
     Cooling Cartridges 
     Prior cooling garments have tended to rely upon heavy and/or bulky components to provide sources of cooling. For instance, most commercial devices based on active cooling mechanisms utilize fluid or gel reservoirs that are not worn by the user and can have a volume greater than 5 liters. Such reservoirs are not portable to any practical extent by the wearer. Even the smallest systems that rely upon gel or ice packs loaded directly into a garment typically require 2-3 kgs (˜5 lbs) or more of ice or gel. Consequently, these packs are heavy, and are typically mounted inside of large pockets, which makes the garment bulky and unsuitable for the majority of mobile outdoor activities such as football, soccer, lacrosse, or running. Indeed these more cumbersome devices are ill-suited even for more sedate environments such as rehabilitative cooling, or job-site cooling. 
     The present technology utilizes small, interchangeable, cartridges (also referred to as cooling cartridges, or water cartridges) that can be secured to many different types of garments, yet can be easily connected to and disconnected from a given garment to facilitate rapid exchanges. The cartridges themselves can span a range of sizes, but are typically in the range 250 ml to 2 liters. The cartridges can be completely or partially pre-filled with water and frozen, or can be filled with ice water, or an ice/water mix. The cartridges can also house other fluids or gels, or can accept salts, for example, to further drop fluid temperatures. The cartridges are typically made from a durable, flexible, leakproof plastic or fabric material, and may be referred to as a bladder. 
     In some embodiments, the cartridges can be pressurized. Such cartridges can be fitted with a nipple that has a quick disconnect capability, and is valved so that the cartridge can be routinely filled from a pressurized fluid source. 
     A cartridge typically has a closeable opening, through which water, ice, or other cooling fluids can be added. The cartridge also has tubing connectors to facilitate rapid connection to and disconnection from the pump and any tubing located inside or on the garment. In a preferred embodiment, a cartridge with a volume of approximately 500 mls is made from a material such as weldable or bondable PVC, and has an opening in one end, the “filling end”, that can accept water and other fluids and is preferably large enough to accept ice cubes, or an ice slurry. To create a leakproof seal, the filling end can be folded once or more and secured with a clip or Velcro™ type fastener. Other closure systems such as press lock seals, screw tops, or friction tops can be envisioned and used. In other embodiments, the cooling cartridge can be completely sealed, and simply pre-filled, such as with a gel or other liquid such as water, through extension tubes. This allows the entire cartridge to be pre-frozen. 
     The connection from the cartridge to the rest of the system can be made using extension line tubes fitted with luer lock disconnects or other water-tight fittings. Such tubes are preferably made from plastic and are small and unobtrusive. The extension line tubes are typically long enough that the cartridge can be removed from the garment, and handled easily. 
     A cartridge preferably sits in a dedicated pouch, pocket or sleeve, on the interior side of the garment. While the garment should be designed to securely anchor the cartridge, the cartridge itself can employ strategies to minimize bouncing or migration during activity by the wearer. Such strategies can include one or more of anchors using materials such as Velcro™, or sling suspensions, as well as rubberized surfaces on the inside surfaces of the garment to increase friction between the cartridge and the garment. Still other approaches include the use of reinforced tabs to prevent kinking of the cartridge, and to prevent the cartridge from crumpling up and collapsing to the bottom of the pouch in the garment. It can also be the case that the pouch on the interior side of the garment is designed to closely match the shape or outline of the cartridge so that the cartridge fits snugly in it—much as a hand fits in a glove—and thereby has little opportunity to move around during activities by the wearer. Magnetic closures or magnetic anchoring strategies can also be employed to seal the cartridge and/or anchor it within the garment. 
     The cooling cartridges, in combination with the extension tube fittings are designed to be rapidly inserted and removed. This is because the compactness and light weight of the system, which are consistent with deployment in vigorous outdoor settings, means that the volume of fluid utilized may only provide effective cooling for about 30 minutes. Thus, to prolong the cooling effect during extended activity, it is important to be able to easily swap out a spent cartridge and replace it with a fresh source of cooling fluid. In addition to luer lock fittings as described above, there are a variety of quick disconnect fittings known to those in the industry that can facilitate rapid exchange and prevent water leakage. In some embodiments, valves can be incorporated into the extension lines of the fittings to prevent leaking during disconnect or to keep fluid moving in the desired direction. Such valved embodiments may permit the garment to be attached quickly to a source of pressurized fluid. 
     While the cooling cartridges are intended to be easily interchangeable, in the sense of being easily removed and replaced, for example, during a game or in the midst of some other activity, there are a variety of embodiments that can extend or enhance the effectiveness of an individual cartridge. In some embodiments, the cartridges can have multiple compartments to house additional cooling components such as dry ice, a gel filled core, or compressed gases. The cartridges can be cooled even further using powered heat exchangers. The cartridges can be made from permeable or semi permeable membranes to control pressure in applications where compressed gases are used or produced. 
     Pump and Other Fluid-Circulating Mechanisms 
     One attribute of the wearable cooling system described herein is the ability to circulate chilled fluids to the cooling surfaces of the garment without the need for an external power source. In preferred embodiments, fluid circulation is accomplished by using a lightweight pump that can function without fixed, external power sources (such as an in-wall power socket). In one embodiment, a micro pump, powered by a small battery, is integrated into the cooling system. The batteries can be of any standard size typically available, such as “AA” “AAA” size cylindrical batteries, rectangular “9V” batteries, or a watch battery size. Where practical, the batteries can be rechargeable, such as by being removed from the pump to be charged by a separate charging system. In some embodiments, the battery is integrated into the pump unit and is rechargeable by plugging the pump into a source of electricity such as a wall outlet. There are a variety of different fluid pumps (e.g., impeller, or diaphragm driven) that suit this application, and a variety of different ways to power the pumps (e.g., battery, or solar power) that are well known in the field. The pump can be turned on or off using a variety of switching devices to interrupt power. In one embodiment, the battery connection can be either switched or removed entirely from the pump. In some embodiments, the switch on the pump can be deployed by the wearer without removing the pump from the garment, if it is possible to feel the location of the switch through the material of the garment. 
     The pump typically sits in a snug pocket or pouch attached to the garment. In most systems the pump is mounted on the interior surface of the garment to facilitate coupling from the pump to the cartridge. The pump is typically mounted in such a way that it can be removed from the garment simply for cleaning and washing and for replenishing the batteries that power it, and correspondingly re-mounted simply after cleaning and washing. Ordinarily the pump does not need to be removed or replaced during the activity for which the wearer seeks cooling unless, for example, the battery needs changing. 
     In some applications, it is possible to pump fluid using the kinetic energy of the wearer. Normal motion during strenuous activity is capable of pumping fluid through elastic channels, and kinetic motion can be transferred to mechanical energy to drive external pumps. In some applications, external forces can be used to drive fluid flow (g-forces in motorsports, for example, or impacts from another player in a contact sport such as football). In other embodiments, cooling liquids can be circulated by pre-pressurizing the system or by using expanded gases from within the system (dry ice, for example). For applications requiring minimal cooling, gravity fed cartridges can feed the cooling surfaces with chilled fluids. For pre-pressurized or gravity fed systems, venting can be achieved using permeable materials in the cooling garment or in the tubing. 
     Tubing Connectors 
     In many embodiments, a flow loop between the pump, cartridge, and cooling surface is made so that the cooling fluid can be circulated for prolonged periods of time, typically driven by a pump. An important aspect of this flow loop is that each component can be detached for cleaning, service, repair, or replacement (e.g., battery replacement, or cartridge replacement). In a preferred embodiment, these components are connected by short lengths of flexible tubing. In some embodiments, the tubing can have multiple lumens, which allow the circulation of additional fluids which have different cooling or flow characteristics. The second lumen, for example, can flow gases released from the heating of dry ice or the expansion of gases from a high pressure gas cylinder. In preferred embodiments, the flow loop is assembled using simple tubing connectors such as barb fittings, or leak proof quick disconnects. In order to maximize the durability and comfort of the system, in preferred embodiments, the flow-loop tubing is integrated into pockets or channels within the garment. 
     In some embodiments, the tubes of the system can be coiled (such as pre-formed in a coiled configuration) in order to avoid kinking. A certain amount of resilience of the tubing is beneficial because a given size of garment has to be able to fit some variation in size of person. 
     Smart Instrumentation 
     Aspects of currently available instrumentation and communication technology permit the integration of a variety of wearable sensors into the cooling garment described herein. The data from these sensors can be communicated wirelessly so that wearers can be remotely monitored in real time. In addition to monitoring the temperature and pressure of the cooling fluid, key biometric data such as core temperature, heart and respiration rate, or even EKG can be monitored and recorded. Performance data such as speed and distance run can also be recorded and transmitted using GPS monitoring systems. This data can be monitored remotely by coaching staff, for example, or by smart application devices that can predict imminent onset of hyperthermia, flag cooling systems that need recharging, or identify athletes that should be advised to alter their activity level. 
     EXAMPLES 
     There are a wide range of applications where the wearable, portable, integrated cooling system described herein offers significant benefits to the wearer. These include active sports such as football, running, or motorsports; outdoor leisure activities; rehabilitative medicine where cooling is required at the site of an injury; as well as veterinary applications. Many industrial or jobsite applications also exist. Several specific embodiments are described in the following examples, which are taken to be illustrative of, and not limiting to, the invention. 
     Example 1: Use in American Football 
     In most areas of the country, football is a summer and/or fall sport that has a long history of hyperthermia problems. While several plug-in ‘sideline’ systems exist to help players cool during workouts, no system exists that is sufficiently portable to allow on field use during games or drills. In an exemplary system, designed for use in active sports such as football, the cooling surfaces are integrated directly into a compression type shirt, with cooling zones located on a combination (such as two or more) of the chest, lumbar region, neck, and arms. Additional (optional) cooling zones can be built into the helmet to cool the head, the shoulder pads, the pants or other padding to provide other integrated cooling options. 
     As described elsewhere herein, the cooling zones can be formed by producing one or more lumens through which water (or other fluids) can flow. This can be achieved with tubing, a bladder, or between two plies of waterproof fabric. Flow through the cooling zones is driven by a battery powered pump. The pump and battery can be housed directly in the shirt, or can be integrated into other equipment such as the shoulder pads or the helmet. 
     Similarly, the cartridges that hold the water or other cooling fluid are installed into a pocket in the compression under layer clothing or directly into other equipment such as the shoulder pads or other padding. As described above, short lengths of tubing can be used to complete the flow loop, and these lengths of tubing are integrated into seams or pockets in the clothing or related gear. To facilitate rapid cartridge exchanges, the cartridge is connected via luer lock fittings or other quick disconnect fittings. The cartridges can be filled with a variety of fluids to provide cooling to the wearer. In the simplest embodiment, ice water is used. In more complex versions, other fluids such as salt water can be used to obtain lower starting temperatures. Even lower temperatures can be achieved by inserting colder inserts into the main cartridge or smaller, separate, chambers. Dry ice, for example, can be used to further chill the cooling fluid. 
     Each non-contiguous portion of lumen may require a separate pump and one or more dedicated cartridges to provide the appropriate cooling effect. 
     In order to monitor the performance of the cooling system and/or the athlete wearing it, a variety of smart sensors can be integrated into the system or used as wearable add ons. GPS sensors, temperature transducers, EKG leads, heart rate monitors, respiration monitors are common examples of sensors that can optionally be included with the system. The information derived from the sensors can be transmitted to the athlete or an independent monitor to help guide activity (increase or decrease effort, increase or decrease pump rates, or change the cartridge). 
     Similar systems can be used for other strenuous sports such as running, lacrosse, and soccer. 
     Example 2: Uses in Motor-Sports 
     Existing cooling systems for racing drivers are generally limited to cars with sufficient space available to install and secure bulky cooler reservoirs. For smaller open wheel cars or karts, no system is small enough to facilitate meaningful use. While recently a system has been marketed for karts, the carrying bag is approximately 12×12×4 inches, and is not practical for on track use. Moreover, existing systems rely on tubing or plastic bladders within a T-shirt or helmet that are uncomfortable and inflexible, particularly when racing seat belts are secured on the driver. In a particular embodiment of the current technology, the cooling shirt includes a cooling surface formed by bonding two layers of waterproof fabric together with a lumen between them that allows fluid flow. This fabric-based lumen provides a thin, flexible, cooling surface that is both comfortable and functional, even when used in the context of normal racing safety gear. Shirt fabrics can also be made from fire or abrasion resistant fabrics to provide a cooling shirt that meets other requirements of the motorsports governing body. The cooling surfaces can also be integrated directly into the racing suit (coveralls) to eliminate the need for a separate undergarment. Similarly, cooling surfaces can be integrated into other pieces of equipment such as helmets, rib vests, head and neck support devices, and even gloves and shoes. The cooling surfaces are connected to a small cooling cartridge as described above. The cooling cartridge can be mounted to the car/kart and then secured with zip ties, Velcro™, or other connecting strategies. A typical volume for the cooling cartridge in this setting is 250 ml to 5 liters. While there are a number of strategies that can be used to turn the pump on and off, motorsports applications typically benefit from an easily accessible switch. This can be a mechanical switch mounted to the steering wheel or other easily reachable location, or an electronically actuated switch that communicates with electronic dash systems or even pit crew and that can communicate with the car/driver via telemetry system. 
     For motorsport applications in particular, the system can be powered by an external source of power that is not included in the shirt or pump. Similarly, other elements of the system can be mounted separately from the clothing, given the space available in the car. The system, as described above, can also be instrumented to allow automatic control of temperature and flow rate. As described in connection with other examples, an important element of the system is to allow rapid exchange of cooling cartridges, such as at pit-stops. 
     Example 3: Use in Rehabilitative Cooling 
     In another preferred embodiment, the system can be built to provide cooling to injured joints or tissues. There are, for example, a variety of devices that provide active (circulated) cooling to shoulders, ankles, or knees post-injury or post-surgery. As described elsewhere herein, existing systems utilize bulky pumps and bulky cooling reservoirs, which makes these systems essentially non-mobile and non-wearable. This is particularly true for patients that are on crutches. The technology described herein allows pumps and cartridges to be integrated directly into the cold wrap, or carried in a small pouch that is connected to the cold-wrap or cooling surfaces. As described above, the ability to easily exchange the cooling cartridge improves the portability of the system, and provides cooling of sufficient duration to provide therapeutic effects. 
     Example 4: Football Jersey 
     This example describes use of a cooling jersey that i works by actively pumping ice water from interchangeable cooling cartridges ( 1 ) through bladders (big wide flat surface area) on the chest and back ( 2 ). The bladders are housed in large pockets and are accessed through side zippers. It is important to smooth out these bladders and the inlet/outlet tubes on the right side of the jersey before each use to prevent kinking. The cooling bladder sits in the larger zippered compartment on the back of the shirt. Below this cooling bladder is the heart of the system- a power pack ( 3 ) that circulates water in a loop between the cartridges of cooling fluid and the bladders. These components and the overall flow loop are shown schematically in  FIG. 1 . The actual components can be visualized in  FIG. 2 . (If instead the version of the system that has the integrated cooling panel is used, one advantage is that it does not kink.) 
     While the tubing and bladders are housed within pockets and channels built into the shirt, they have a tendency to move around a bit between uses. Therefore an important aspect of using the shirt is to spend a few minutes after putting on the shirt to smooth out the bladders and adjust the position of the tubes to be comfortable and to make sure there are no kinks in the system. It helps to have a teammate or equipment manager spend a few moments helping to prep the system and load the cooling cartridge before activating the pump. Alternatively, the shirt can be carefully layed out on a table, before flattening the bladders, connecting the cooling cartridge and activating the powerpack. Once the bladders are inflated with water and circulating to both front and rear bladders, the shirt can be carefully put on. Again, it may be necessary to adjust the bladder and inlet/exit tubes for it to be comfortable and kink free. 
     A button on the battery case (circle,  FIG. 3 ) in the powerpack activates the entire system. This button can be felt through the neoprene bag and can be activated without removing the battery case. The button can be pressed once to turn the pump on, and pressed again to turn it off. Two rechargeable batteries in the waterproof battery case (accessed by removing two screws) power the system for 2-4 hours. When the pump is running, the wearer should be able to feel a gentle vibration from within the powerpack. 
     The cooling capacity of the system is driven almost entirely by the amount of ice in the cartridge. The phase change of ice (solid ice at 32° F. to liquid at 33° F.) removes significantly more heat than a similar volume of liquid water warming from 33 to 34 degrees. Therefore, it is advisable to pack as much ice as possible into the cartridge, before filling it the rest of the way with cold water. It is useful to fold the top of the bag close to the waterline (thereby minimizing the air pocket in the bag) before sealing it with the orange closure clip ( FIG. 4 ). 
     The clips may be a little tricky to use at first, but a wearer will recognize that the clear plastic of the cooling cartridge bag has to slide in between the yellow insert of the closure clip and the outer orange shaft. The wearer may try this closing step a few times on a dry bag before trying to do on a wet bag. Once the bag has been clipped a few times, it is much easier to close along the same fold line. Note also that the bag will drain out if due care is not exercized, so grasping the tubes and holding them up above the bag is recommended. The cooling cartridge connects to male and female fittings inside the large back pocket. It is possible to pull those fittings out, and turn male ‘spinlock fittings’ firmly about ¼ turn to engage and connect to the female fitting. Again, the wearer will benefit from practicing connecting/disconnecting these fittings a few times with a dry system before loading one with water. Once the bag is filled, and the fittings connected, the cooling cartridge can be placed into the large rear zippered pocket with the orange closure clip end in first. 
     The excess length of the closure clip typically goes through the small button hole on the upper left of the rear pocket. It is possible to insert the excess length of the tubing into the pocket, again, taking care not to kink the tubes. To turn on the pump, the wearer can feel for the on/off button on the battery case directly under the logo on the power pack. In practice, this process may be easier if done with a partner. Alternatively, it is possible to make all of the connections with the shirt flat on a table or bench, before turning on the system, and putting the jersey on. 
     If one or both bladders do not inflate with cold water, the wearer can check for kinks on the right side of the body. Kinks are most likely to occur near the exit from the bladders to the Y tubing. By flattening these joints and repositioning the Y tubing flow can be re-established. Once the ice is gone from the pack and the water is warmed, the wearer can quickly add a new cooling charge by taking a new, pre-filled cartridge from the cooler. Alternatively, it is possible to simply remove the clip, drain most of the water, and add ice to the warmed cartridge. The pump can be left running while the wearer quickly disconnects and reconnects the new cartridge. Each charge should last about 15 minutes. 
     At the end of a session of use, the wearer can switch off the motor and carefully remove the shirt by peeling it up and turning it inside out as it is removed. It is possible to turn the shirt right side in, then remove and drain the cooling cartridge. Then the motor pack can be carefully removed. Connecting the remaining male and female fittings so that these tubes do not migrate back into the channels in the shirt is advised. In this example, the connection is for convenience only, and must be undone to properly reconnect the powerpack and cooling cartridge. 
     The shirt can be hand washed with mild detergent with the bladders still inserted and hanged dry. To recharge the batteries, ther user can open the power pack pouch and remove the battery case door with a small Phillips head screw driver. Recharge or replace the AA batteries. A good rechargeable battery should last more than 2 hours, but the system should be recharged between uses. 
     Example 5: Other Embodiments 
     There are a variety of related applications and capabilities that can be built into this portable, wearable temperature control system. The system can be easily adapted for veterinary applications. The system can be altered to provide heating rather than cooling. The system can be powered by outside power supplies. The temperature control can be provided or enhanced by means other than cold or hot fluids. Piezo electric heat exchanges, for example, can be used to transfer heat to or from the system. 
     While the system is designed to be largely integrated into clothing, it can easily be built into belts or packs that can be worn or carried outside of the clothes or the gear. It can also include padding or shields to protect the wearer from impact, and can similarly help protect the cooling system. 
     The system can include a wide range or sensors and/or alarms to help guide decisions. 
     The system can include a wide range of fluids, gases, and additives that can provide temperature control. 
     The system can be secured using elastic belts or compression fabrics to minimize motion while participating in active sports. 
     The system can additionally be integrated with a hydration system and configured so that a wearer can drink from one cartridge while being cooled by the other. It is understood that one aspect of mitigating onset of heat shock is to remain hydrated. 
     All of these additional embodiments are intended to be covered by this disclosure. All references cited herein are incorporated by reference in their entireties. 
     The foregoing description is intended to illustrate various aspects of the instant technology. It is not intended that the examples presented herein limit the scope of the appended claims. The invention now being fully described, it will be apparent to one of ordinary skill in the art that many changes and modifications can be made thereto without departing from the spirit or scope of the appended claims.