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Charlie Brown

Cool treatment helps cardiac arrest patients

Fewer than 10% of people who have cardiac arrest survive it. According to Charlie Brown, M.D., Piedmont Heart Institute cardiologist, there are various reasons. Without a heartbeat, the brain starts to degenerate, and certain chemical processes take place, accelerating cell death.

A person’s survivability depends on the time of cardiac arrest to the time blood circulation is re-established. “By starting hypothermia - by reducing the body’s core temperature - you actually stop the internal injury process that takes place on a chemical basis,” Dr. Brown says.

How hypothermia is instituted can vary. The main goal is to try to drop the temperature down to 32 degrees Celsius within about three to six hours of the time of the arrest. That’s the magic window of achieving hypothermia. If a patient happens to be picked up by an ambulance equipped with hypothermic devices, paramedics can begin the process.

For example, a hypothermic cooling blanket could be applied, and ice packs placed in high-circulation areas such as the axilla, underarms, groin and around the head. Once the patient is in the hospital, more formal cooling devices are available, such as sophisticated cooling blankets and a device inserted into the abdomen's main vein to exchange heat internally very aggressively. “We will also institute other sedative drugs to try to calm the brain’s actions,” he says. “Muscle-paralyzing drugs can be administered to prevent shivering, which consumes oxygen.”

Therapeutic hypothermia has been around and accepted for almost a decade but has been slow to evolve in common practice. Dr. Brown admits it’s an unusual therapy but quite effective. Piedmont Hospital is one of the very few in Georgia that offer the treatment.

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