Cooling Therapy Helps People Survive Cardiac Arrest
Posted February 14, 2008
Updated February 15, 2008
Raleigh, N.C. — Cardiac arrest presents more danger to people than heart attacks. Local county health systems, however, are using a special body-cooling therapy has improved patients' chances of survival.
With a heart attack, a person feels chest pain or other related systems, but remains conscious. In cardiac arrest, the heart goes into sudden atrial fibrillation: it stops pumping blood to the brain, and the person is unconscious.
Time is of the essence for survival and to save the brain from injury.
Cecelia Barbee, 43, of Raleigh, only remembers a severe thunderstorm the night she went into cardiac arrest in August 2007. She woke up to the sound of thunder, then went back to sleep.
Eight-year-old Hydeah, who was sleeping next to her mom, noticed something wrong, however.
"That's when Hydeah came in the room and said, 'Uncle Reed, Uncle Reed! Mama dead, Mama dead!'" said Willis Hilton, Barbee's brother, with whom Barbee was staying with at the time.
When Wake EMS arrived, they shocked Barbee's heart back into rhythm, although she remained in a coma.
That moment held the greatest risk for Barbee's brain, as the low oxygen supply started brain injury, and that was also when paramedics began the cooling therapy, known as hypothermia, or "low heat."
"What hypothermia does is it stops that process and prevents ongoing injury to the brain," Dr. Paul Hinchey, with Emergency Medicine at WakeMed, said.
EMS workers began induced hypothermia with a cold saline intravenous line and cooling body wraps. At WakeMed, staff inserted a special cold catheter into a large vein in Barbee's leg. That procedure helped bring her body temperature down from a normal 98.6 degrees Fahrenheit to 89.6 degrees for 24 hours.
Wake EMS, WakeMed and Rex Health Care began using the therapy in the fall of 2006.
"We've seen a pretty significant improvement both in resuscitation rate, in terms of the number of people who survive," Hinchey said, and "in neurological outcomes."
Barbee said she was confused and had trouble walking when she first came home.
She has recovered to the point where she can walk normally, however. Although her memory sometimes falters, relatives said Barbee has greatly improved.
"There were a lot of good doctors at the hospital that worked really hard to help me get to where I was at," said Barbee.
Wake County EMS, WakeMed and Rex Health Care have been gathering data on the effectiveness of induced hypothermia. Although results will be released in a few months, early indications – including Barbee's case – are proof that the therapy is helping, Hinchey said.
Wake County was among the first in the country to implement the protocol for certain cardiac-arrest patients. UNC Hospitals had a strong role in developing the therapy, and Orange County has also implemented its use.
Additionally, Duke University Medical Center uses induced hypothermia for many cardiac-arrest patients, although Durham County EMS does not.