UNC Hospitals using hypothermia therapy to prevent brain damage after cardiac arrest
CHAPEL HILL - Starting Oct. 1, the Emergency Department at UNC Hospitals began using induced hypothermia or cooling therapy to help prevent brain damage in people who have been revived after their heart stopped.
Oct. 2, 2007
UNC Hospitals using hypothermia therapy to prevent brain damage after cardiac arrest
CHAPEL HILL - Starting Oct. 1, the Emergency Department at UNC Hospitals began using induced hypothermia or cooling therapy to help prevent brain damage in people who have been revived after their heart stopped.
The treatment essentially involves injecting cold saline solution into the patient’s veins and covering the patient with cold blankets until the body temperature drops from the normal level of 98.6 degrees Fahrenheit to about 92 degrees. The patient is then kept in this mild hypothermic state for 24 hours and then gently rewarmed and allowed to wake up.
Cooling the patient reduces the brain's need for oxygen, helping to minimize the damage that typically occurs after the heart stops and blood flow to the brain is interrupted. It is the same method that was used recently to treat Buffalo Bills football player Kevin Everett for a life-threatening spinal cord injury. Some medical experts believe the cooling treatment may have saved Everett from paralysis.
“Surprisingly, most of the damage to the brain actually occurs after the heart is restarted,” said Dr. Laurence Katz, an emergency physician at UNC Hospitals who has been researching the use of hypothermia therapy for 17 years.
“During cardiac arrest, the brain is like a smoldering fire,” Katz explained. “The blood returning to the brain carries toxins that act like gasoline being poured on a smoldering fire, igniting a pathway of devastation that causes irreversible brain damage over a 24-hour period. Hypothermia helps put out that fire so the brain has a chance to recover function.”
Researchers began investigating use of induced hypothermia as a treatment for brain and spinal cord injury after there were several documented cases in the 1970s and 1980s of people who completely recovered after near-drowning incidents in cold water, even though they had been clinically dead for more than an hour. Without induced hypothermia therapy, less than 10 percent of people who suffer a cardiac arrest outside of a hospital make it home from the hospital alive. Most patients die because of brain damage while a significant number of survivors suffer devastating brain injury.
Hypothermia research in the 1980s through early 2000s at the International Resuscitation Research Center in Pittsburgh, where Katz did some of his training, led to two large clinical trials conducted in Europe in 2002. These studies reported that inducing hypothermia early after resuscitation from cardiac arrest improved the patient’s chances of a good neurological outcome by more than 50 percent.
Katz and colleagues at UNC have trained emergency medical technicians in Orange County how to begin administering the cooling therapy while the patient is en route to UNC Hospitals. Ultimately they hope to teach the technique to hospitals and emergency medical technicians across North Carolina, so that it becomes a statewide standard of care.
UNC Hospitals is the first university-based medical center in North Carolina to implement induced hypothermia therapy as a treatment for cardiac arrest, which is also known as ICED (induced cooling to eliminate deficits) therapy. Emergency medical technicians and physicians in Wake County began using the therapy in October 2006. Katz assisted Drs. Brent Myer and Paul Hinchey in writing the hypothermia protocols currently being used in Wake County.
Media contact: Stephanie Crayton, (919) 966-2860 or scrayton@unch.unc.edu
ABOUT UNC HEALTH CARE
The UNC Health Care System is a not-for-profit integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care. UNC Health Care is comprised of UNC Hospitals, which is ranked among the top 50 in the nation in six specialties by U.S. News & World Report and ranked one of the country’s 41 best on the Leapfrog 2007 Top Hospitals list; the UNC School of Medicine, a nationally eminent research institution; community practices; home health and hospice services in seven central North Carolina counties; and Rex Healthcare and its provider network in Wake County. UNC Health Care also manages Chatham Hospital in Siler City.
