Cool Technique Has Potential to Increase Mortality

Richmond University Medical Center (RUMC) in Staten Island, NY has established a new technique for heart attack patients that are brought into their emergency room: hypothermia treatment. The thought process behind the new protocol is that the cooling of the body will actually slow down a patient’s metabolism and give him or her a better chance of surviving with a reduced risk of brain damage. The new protocol was in effect as of January 5, and was implemented by the New York City Fire Department and Emergency Medical Services, after it showed its potential in emergency departments and intensive care units last summer.

In order to be eligible for induced hypothermia, a patient must be experiencing a heart attack or cardiac arrest, as well as have lost and regained a pulse. These patients are given an intravenous ice saline and then wrapped in a two-part cooling suit. Patients who are treated with this technique in the first hour are in the best position to benefit, with the body temperature being lowered to between 32 and 34 degrees Celsius over a period of 12 hours, and then gradually brought back up to 37 degrees Celsius as the sedation is reduced.

According to RUMC, the technique was performed six times between July and December 2008, with three “favorable outcomes,” which is defined as “life-saving successes for patients who would not have survived before.” While this procedure has the potential to save patients’ lives, Dr. Asura, of RUMC, was quick to explain that not all patients will respond to this treatment. “Although therapeutic hypothermia is an important treatment modality, the number of patients who would be candidates for this treatment is limited. Candidates for this new procedure are those who have experienced the return of spontaneous circulation return of pulse and blood pressure after cardiac arrest and who remain profoundly, neurologically impaired — comatose,” Asura said.

To read more about therapeutic hypothermia, visit the resources below.

Post-resuscitation Care/Therapeutic Hypothermia The Cooling Effects of Therapeutic Hypothermia eMedicine: Therapeutic Hypothermia