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August 6th, 2009
10:59 AM ET

Cooling catches on for cardiac arrest patients

[cnn-photo-caption image= caption="Therapeutic hypothermia patients receive a chilled saline solution and are put under a cooling pad or blanket."]

By Caleb Hellerman
CNN Senior Medical Producer

PHILADELPHIA, Pennsylvania (CNN) - Seated on a jetliner, Dr. Mary Gallagher and her husband, Don Dietrich, were about to take off for an anniversary vacation in Puerto Rico. But a glance at her husband of five years set off an alarm - he was gasping for breath. Gallagher, an anesthesiologist, knew the signs: Dietrich was in cardiac arrest.

Gallagher ran to tell the pilot; someone called 911 from a cell phone; another passenger started CPR. Paramedics appeared and then Gallagher made a crucial decision: Even though protocol called for Dietrich to be taken to the nearest hospital, three miles away, she insisted he go twice as far, to the University of Pennsylvania Hospital and its Center for Resuscitation Science.

By the time Dietrich hit the emergency room, he had a weak pulse. At most hospitals, standard treatment is to sit tight and hope for the best. But at UPenn, doctors hooked Dietrich to an intravenous line of chilled saline solution, dropping his body temperature to a cool 91 degrees.

More than 90 percent of people who suffer cardiac arrest, as Dietrich did, end up dying. For more than a decade, there has been evidence that cooling a patient's body - or therapeutic hypothermia - improves those odds. No one quite knows why, but it's thought that the cold reduces the body's need for oxygen and slows the deadly chemical cascade that sets in when oxygen isn't circulating because the heart stopped beating.

Yet, as one 2007 paper put it, "implementation of hypothermia is lousy." In 2006, researchers at the University of Chicago found that just 34 percent of critical care physicians, and just 16 percent of emergency physicians, had ever attempted to use hypothermia to treat cardiac arrest. Makers of cooling equipment say fewer than 300 hospitals, out of more than 6,000 nationwide, have the necessary equipment.

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Filed under: Health
soundoff (2 Responses)
  1. jim

    The healthcare debate is focused on fixing healthcare which we all realize is flawed. But the congress and the president are ready to force insurance on everyone While overlooking the bigger picture the medical cost itself which ultimately drives the cost of any insurance premium public or private The United States is the greatest country in the world and yet we can’t decide on a uniform cost for procedures, prescriptions, doctors, or hospitals. No healthcare program can work unless mandated pricing is in place first because of greed, if healthcare is passed first then everyone, the government, the insurance companies, the doctors, the hospitals, the drug companies will take all the extra money and never look to lower the medical costs.

    August 8, 2009 at 10:06 am |
  2. Leslie

    Hypothermia therapy would catch on faster if you would explain the term "reperfusion injury." Brain damage occurs when the patient is given too much oxygen too fast. Traditional treatment is *guaranteed* to cause brain damage.

    Any hospital that doesn't use hypothermia therapy is committing medical malpractice. It's terrifying!

    August 7, 2009 at 9:31 am |