Therapeutic hypothermia technique becomes more advanced

July 26, 2011 7:31:02 PM PDT
A recent study is confirming the benefits of a treatment used to limit damage from a heart attack and doctors here in the Bay Area say the technique, known as therapeutic hypothermia, is also becoming more advanced.

When cardiac arrest patients are being rushed to the emergency room the clock is ticking, not just for their hearts, but also their brains, which can become vulnerable after suffering a loss of oxygen. So along with restoring heartbeat, E.R. teams are often targeting the patient's body temperature as well.

"To cool them down, you want to decreased their metabolic rate," said Elisa Guzman, R.N.

Guzman is the charge nurse in the emergency room at California Pacific Medical Center in San Francisco. She says initial steps involve placing ice packs and cooling blankets, but her team then employs a newer technology -- a temperature controlled device used to inject pre-cooled saline solution into the patient's bloodstream.

"This would go to the torso," explained Guzman. "It goes directly into the vascular system. So it cools everything down, it slows everything down."

"And by cooling the brain, you reduce the demand for both oxygen and glucose and it prevents damage," said Thomas Peitz, M.D. from CPMC.

Peitz heads up the Department of Emergency Medicine. He says while the concept of cooling the body to protect the brain isn't new, the technology has become more effective.

"Our goal is to reduce core temperature, which is normally at 37 degrees centigrade. We want to lower it to 32 degrees centigrade. And the goal is to do that in the first two to three hours," said Peitz.

Now, a multi-center study in Minnesota is backing up the benefits of that 5-degree drop. It found, that of the patients who survived their heart attacks, 92 percent showed no serious neurological damage with the cooling protocol. That's a 15-percent improvement over the standard protocol.

Researchers say the technique helps shield the brain in the first hours after full blood flow is restored, protecting it from pressure-related trauma. They believe the findings could now lead to increased use of therapeutic hypothermia for recovering heart attack patients.

Doctors say once the body temperature is lowered in heart attack patients, they're usually kept in that state for 24 hours, and then gradually re-warmed over an eight-hour period.

Written and produced by Tim Didion


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