Hypothermia for revived cardiac arrest patients appears safe

October 08, 2001

DALLAS, Oct. 9 - Reducing the body temperature of someone revived from cardiac arrest is feasible and safe, but cooling time must be faster to make it a practical treatment, according to a report in today's Circulation: Journal of the American Heart Association.

Those who are revived after cardiac arrest often suffer brain damage because the flow of oxygen to the brain was shut off for too long. "Many surviving patients are left with significant neurological disabilities," says senior author J. C. Grotta, a neurologist at the University of Texas-Houston Medical School. In animal studies, lowering body temperature (hypothermia) has consistently reduced brain injury. The sooner hypothermia begins and the longer it lasts, the less chance for severe neurological damage. Exactly how hypothermia protects the brain is unclear. However, reducing body temperature decreases the brain's demand for oxygen, reduces the release of nerve-killing chemicals, suppresses inflammation, and stabilizes cell membranes.

Grotta and his colleagues studied nine patients whose cardiac arrests did not occur in the hospital. After acute life support, each patient was sedated and wrapped in two cooling blankets, one around the torso and the other around the pelvis and legs. The goal was to lower body temperature to 33 °C (91.4 °F) within 120 minutes after initiating cooling and maintaining that temperature for 24 hours.

Four of the patients survived, three of them without neurological disabilities. The fourth survivor went home but required 24-hour supervision due to memory problems. Achieving a body temperature of 33 °C proved a slow process taking an average of 301 minutes (1 and ½ hours) in some individuals. Initiating hypothermia in the nine patients took between 40 and 109 minutes, and averaged 78 minutes.

"Much of this time was spent obtaining informed consent," Grotta says. "An average of 46 minutes was required obtaining the patient's or family's consent to perform hypothermia treatment." It took an average of 391 minutes (6 ½ hours) from cardiac arrest until the patient's temperature dropped to 33 °C. The time from hypothermia initiation to 33 °C took 90 to 690 minutes and averaged 301 minutes (5 hours). "Mild to moderate hypothermia appears feasible and safe, especially when the poor prognosis after cardiac arrest is taken into account," Grotta says. "It warrants further study, but shortening the time to hypothermia will be important in further evaluations." The team did not assess the efficacy of the technique.

The National Institutes of Health supported this research.

Co-authors are R. A. Felberg; M.D.; D.W. Krieger; M.D.; R. Chuang, D.E. Persse M.D.; W. S. Burgin; S.L. Hickenbottom, M.D.; L.B. Morgenstern; M.D. and O. Rosales, M.D.
CONTACT: For journal copies only,
please call: 214-706-1396
For other information, call:
Carole Bullock: 214-706-1279
Bridgette McNeill: 214-706-1135

American Heart Association

Related Cardiac Arrest Articles from Brightsurf:

Outcomes for out-of-hospital cardiac arrest during COVID-19 pandemic
This study used a large US registry of out-of-hospital cardiac arrests to asses the association between the COVID-19 pandemic and the outcomes of out-of-hospital cardiac arrests, including in areas with low and moderate COVID-19 disease.

Cardiac arrest is common in critically ill patients with COVID-19
Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among patients aged 80 or older, finds a study published by The BMJ today.

In-hospital cardiac arrest in COVID-19
Outcomes of in-hospital cardiac arrest among patients with COVID-19 are examined in this case series.

New risk tool developed for cardiac arrest patients
Experts have developed a risk score to predict cardiac arrest patient outcomes.

Intravenous sodium nitrite ineffective for out-of-hospital cardiac arrest
Among patients who had an out-of-hospital cardiac arrest, intravenous sodium nitrite given by paramedics during resuscitation did not significantly improve their chances of being admitted to or discharged from the hospital alive, according to research presented at the American College of Cardiology's Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

Getting to the heart of epinephrine use in pediatric cardiac arrest patients
The effectiveness of epinephrine treatment during resuscitation of adult patients with cardiac arrest is generally promising, but little is known about its effects in pediatric patients.

Bystanders can help more cardiac arrest victims survive
Only 8% of Americans survive cardiac arrest outside a hospital, but that percentage could increase significantly if bystanders recognize cardiac arrest and perform simple lifesaving tasks, a UVA Health physician says in a New England Journal of Medicine article.

Opioid-related cardiac arrest patients differ from other cardiac arrests
People who suffer cardiac arrest due to an opioid overdose are younger, have fewer chronic medical conditions and may be more likely to be to receive bystander CPR, according to a review of emergency response records in Maine.

Selective coronary angiography following cardiac arrest
In the current issue of Cardiovascular Innovations and Applications volume 4, issue 2, pp.

Sudden cardiac arrest in athletes: Prevention and management
It's marathon season, and every so often a news report will focus on an athlete who has collapsed from sudden cardiac arrest.

Read More: Cardiac Arrest News and Cardiac Arrest Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.