Lifewatch: Icy treatments revive the dead

Reported by Claire Hosmann - bio|email
Posted by Debra Worley - email

(WECT) - As many as 325,000 Americans die every year from sudden cardiac arrest.  Only 5% survive when it strikes.

Living through a cardiac arrest depends on the speed of emergency help.  If the heart isn't restarted within five minutes, the chance of recovery drops dramatically.

Bill Bondar, 62, arrived home energized from a jam session with his new band when he went into cardiac arrest.  His wife, Monica, remembers the exact spot where her husband hit the ground.

"When I looked in his eyes, I was looking at a dead man," said Monica.

Paramedics were able to restart Bill's heart, but he was in a coma.  Doctors chilled his body by 6º to save his brain.

"When you're in that in-between -- and that's where most patients are after cardiac arrest -- I believe that cooling is just vital, particularly to protect brain function," said Dr. Lance Becker.

Becker is working on the ice slurry for a new, faster way to cool patients in the critical minutes.  Tiny slivers of ice and saline would be injected into a patient in the ambulance.  The doctor said the slurry works faster and gets colder than the saline, blankets, or pads doctors currently use.

"They transfer far, far, far more cooling capacity than just ice water, so you can think of it as a super dose of ice-cold saline," said Becker.

Researchers in California are also working on an icy solution that's sprayed through the nose to cool the brain during cardiac arrest.

Dr. Becker said once a patient's hearts have been stopped for five minutes, every minute after reduces the chance of survival by 10 percent.  Doctors say the cooling technique reduces the amount of oxygen the brain and heart need to keep working.

For more information, please contact:
Center for Resuscitation Science
University of Pennsylvania

BACKGROUND: Every year, 250,000 people die from cardiac arrest, also called sudden cardiac death. It's estimated 95 percent of people who experience cardiac arrest don't' survive it. The most common cause of the condition -- which happens when the heart stops pumping -- is heart attack.

Another common cause is an irregular heartbeat, which often goes undiagnosed. "For a very large percentage of people who get cardiac arrest, they don't know the have heart disease and they don't have a symptom," Lance Becker, M.D., Director of the Center for Resuscitation Science at the University of Pennsylvania in Philadelphia, told Ivanhoe.

During cardiac arrest, brain death can occur in four to six minutes, and brain damage can continue for hours or days. Dr. Becker says the three techniques that can help save patients from brain death -- and thus death -- are CPR, shocks to the heart from an external defibrillator and cooling treatments, also called therapeutic hypothermia.

SURVIVING CARDIAC ARREST: Bill Bondar is one of the 5 percent of people who survive cardiac arrest. When he arrived at the emergency room, he was comatose. "No movement, no speech, no responsiveness, and so that's a condition that we would be very worried about," Dr. Becker said. Dr. Becker's team saved Bondar's life by bringing his body temperature down 6 degrees Fahrenheit after they restarted his heart. Doctors jump-started his body-cooling process with two liters of ice cold saline and then continued to pull his temperature down with a cooling blanket. Experts believe this kind of cooling process protects the brain by reducing the amount of oxygen that cells need to stay alive.

Building on this hypothesis, Dr. Becker is developing a technique that brings down body temperature more quickly. Called an ice particle slurry, Dr. Becker administers saline that has tiny particles of ice mixed in. The slurry is designed so that when it melts, it turns into biologically perfect, hyper-cooled saline. "When you inject something like that ... into the vein of an animal, the temperature responds in seconds," Dr. Becker said.

THE WAY OF THE FUTURE? Experts are so confident in the benefits of therapeutic hypothermia for cardiac arrest patients that they are pushing for policy change. A New York City protocol that went into effect January 1st of this year requires city ambulances to take many cardiac arrest patients only to hospitals that use cooling therapy to reduce the chances of brain damage -- even if it means bypassing geographically closer emergency rooms. New York City, Seattle, Boston, Miami, Vienna and London have all adopted the policy.

Copyright © 2009 Ivanhoe Broadcast News, Inc.