Cooling Therapy Saves Cardiac Patients

Wednesday, August 19, 2009

Cutting-Edge Technology Provides Damage Control

Milwaukee, WI, August 19, 2009—Using a brain-preserving cooling treatment called therapeutic hypothermia, a Columbia St. Mary’s cardiac specialist saved the life of Dale Coffey, a 41-year-old Indiana man, who suffered a heart attack while at a family camp in Elkhart Lake last month.

“Hypothermia therapy, which decreases the body temperature to about 92ºF, can stop or slow brain damage after a cardiac arrest which deprives the brain of blood flow and oxygen. Iced saline is pumped into a patient intravenously and a cooling blanket is placed on the patient’s body,” according to Dr. Robert Roth, the Columbia St. Mary’s cardiologist who instituted the hypothermic protocol at Columbia St. Mary’s Hospital Ozaukee.

“Mr. Coffey had no history of cardiac problems. In fact, he was a distance runner. When he had a cardiac arrest, his family realized what was happening and his wife immediately began to perform CPR. An AED [automated external defibrillator] was also available at the campground where the family was staying, and he was shocked five times before the paramedics arrived,” Dr. Roth said.

“The patient was taken to St. Nicholas Hospital in Sheboygan with a stable heart rhythm, but he was not conscious. The doctor at St. Nicholas recognized that Mr. Coffey needed specialized treatment that could be provided at Columbia St. Mary’s Hospital Ozaukee, and he was transferred,” Dr. Roth said. All of this happened within about 1.5 hours, which is key when using hypothermic therapy. During this time, he was also heavily sedated and placed on a ventilator or breathing machine.

Inducing hypothermia is a delicate process, which is why it has not been adopted by all hospitals. If the body is cooled too much or too little, a patient can develop additional problems or other organs can fail. However, Columbia St. Mary’s has acquired new technology that has taken the guesswork out of the procedure.

“Although we have used the hypothermia treatment in the past, this was the first time we used the Intravascular Temperature Management Therapy (IVTM) device developed by Alsius Corporation. Columbia St. Mary’s is one of the first in the region to use this technology, which auto-regulates the body temperature monitoring it and allowing it to hit a precise target and to keep it there,” Dr. Roth said.

After Mr. Coffey was kept in a state of hypothermia for about 24 hours, he was rewarmed over the next 24 hours. By the morning of the second day when his body was returned to normal temperature, he was responding and communicating with his family.

The third day, a heart catheterization was performed to open one blocked artery. "When Mr. Coffey came to us, his heart was not pumping well, maybe at about one-third of normal function,” Dr. Roth said. At discharge, however, after use of the hypothermia treatment and the placement of a stent, his heart function was excellent. We were very pleased, and so were the patient and his family. He has suffered no complications and has gone back to an active life,” he said.

While he doesn’t have any memory of his heart attack or the hypothermia treatment, which is normal, Dale Coffey is extremely grateful for the innovative and caring treatment he received from Columbia St. Mary’s. “My wife and family have told me that the care was exceptional and I’m very pleased with what I experienced in the days following the hypothermia treatment and my heart catheterization,” he said. “I’ve been told I can resume my former exercise routine, and I’m currently in a cardiac rehabilitation program three times a week.”

Columbia St. Mary’s has not used the IVTM on enough patients yet to have a statistically meaningful analysis of its effectiveness. “I expect that there will be at least 15 patients per year who will benefit from it,” Dr. Roth said.

“Out-of-hospital cardiac arrest claims the lives of more than 300,000 people each year in the U.S. and leaves thousands of others neurologically damaged. Hypothermia treatment stands out as one therapy that can improve patients’ survival with minimal brain damage,” Dr. Roth said.




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