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August 26, 2003
Cooldown May Reduce
Neurologic Damage After Cardiac Arrest
Oklahoma
City—Again leading the state in heart care, the Oklahoma Heart Hospital
implemented a new protocol last week that reduces a patient’s body
temperature to 32 to 34 degrees Celsius (89 to 93 F) for a 24-hour
period following cardiac arrest.
“When patients
must be resuscitated for long periods after cardiac arrest, they often
suffer brain damage because the flow of oxygen to the brain is shut off
for too long,” said Dr. Brook Scott, an interventional cardiologist at
the Oklahoma Heart Hospital. “By decreasing a patient’s body
temperature, we reduce the chance of brain injury.”
The benefits
were recently published in Circulation, an American Heart Association
journal. Studies have shown that the sooner hypothermia begins and the
longer it lasts, the less chance for neurological damage. Lowering a
patient’s temperature decreases the brain’s demand for oxygen,
suppresses inflammation and stabilizes cell membranes.
In order to
reduce a patient’s temperature, several measures may be used including
ice packs, cooling blankets and chilled intravenous fluids. The most
difficult roadblock is time. On average, it can take five hours to get a
patient’s temperature to drop to 33 C. Even with the time factor, the
results are promising.
The Oklahoma
Heart Hospital recently implemented the hypothermia procedure in
patients who suffer cardiac arrest. “The results are very encouraging,”
said Dr. Scott. “One of our patients appeared to have sustained severe
neurologic injury following a heart attack. By the time she had reached
the emergency room, she was in a deep coma and suffering recurrent
seizures. The heart attack was successfully treated with emergent
balloon angioplasty and the hypothermia therapy was initiated
simultaneously. She walked out of the hospital five days later with no
residual neurologic injury.”
Thanks to
cardiovascular procedures, cardiologists may successfully manage cardiac
arrest due to a heart attack. “But as cardiologists, we are frequently
frustrated when we’ve been successful in restarting and stabilizing a
patient’s heart, but the patient is left with devastating long-term
neurologic injury,” said Dr. Scott. “By coupling hypothermia treatment
with acute interventional cardiovascular procedures, we hope to not only
save the patient’s life, but improve the quality of life after cardiac
arrest.”
Oklahoma Heart
Hospital is a partnership between Mercy Health Center and Oklahoma
Cardiovascular Associates, along with other cardiovascular physicians.
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