April 05, 2007
Cooler Heads Prevail in Cardiac Arrest
Heart Attack Patient Benefits from Innovative Technology at UCSD Medical Center
UCSD Medical Center cardiology and neurology specialists are using a novel method to save the lives of patients in cardiac arrest.
Using an innovative technology that rapidly cools the blood, the body temperature of the cardiac arrest patient is lowered, protecting the brain from damage that can result immediately after a heart attack.
Adopted at UCSD Medical Center in October 2006, the technique has been used to save multiple lives and is being implemented at hospitals worldwide.
Alabama resident Lee Murray, a 51-year-old father of two, is one of the first patients at UCSD Medical Center to benefit from the cooling method. On a visit to San Diego in March 2007, he competed in a 5K run then collapsed into a state of unconsciousness. Nearby personnel at the San Diego Convention Center performed CPR before Murray was transported via ambulance to UCSD’s emergency room in Hillcrest.
“I am extremely lucky. As an avid runner, weight trainer and tennis player, I had no idea I had a time bomb in my chest,” said Murray, Director of Lawson Systems, Applications and Support, at University of Alabama Health Services Foundation. “I believe my treatment occurred at the only time and place that I could have had a positive outcome. CPR and UCSD’s medical teams saved my life.”
The 24-hours following cardiac arrest represent a vulnerable period in which the body releases damaging enzymes. By cooling the body, the risk of brain damage is reduced. In February 2002, The New England Journal of Medicine reported that therapeutic mild hypothermia increased the rate of a favorable neurological outcome and reduced mortality in patients who have been successfully resuscitated after cardiac arrest caused by ventricular fibrillation.
On the day of Murray’s cardiac arrest, following guidelines issued by the American Heart Association, UCSD Medical Center’s cardiac team reduced his body temperature using a special catheter equipped with a temperature control element on its tip. The catheter is inserted into a large vein in the leg, and up to the inferior vena cava, the major vein carrying blood back to the heart. Once inside the body, the blood was cooled as it flowed by the element. This type of cooling therapy provides a safe and rapid way to lower the patient’s body temperature without removing blood or infusing liquids.
During Murray’s hospitalization, two stents were inserted into his heart to restore the normal flow of blood and oxygen, a common procedure for heart attack patients.
UCSD Medical Center was the first hospital in San Diego to offer this technology, which basically changes blood temperature by circulating either cold or warm saline solution through the catheter. The cooling technology was developed by InnerCool Therapies, which was founded by John Doback, M.D., a graduate of the UCSD School of Medicine.
“While on a respirator, the body is cooled to 33 degrees Celsius, a temperature that offers critical protection of the brain during the crucial hours after a heart attack. After 24 hours, the patient is slowly warmed and revived. Initial results have been excellent,” said Ori Ben-Yehuda, M.D., Director of Coronary Care Unit, UCSD Medical Center and Associate Clinical Professor of Medicine at UC San Diego School of Medicine. “This protocol is key to improving the survival rate of cardiac patients and to protecting the quality of life after recovery.”
“Mr. Murray’s outcome represents an amazing effort among the emergency department, coronary care unit, and the cardiac catheterization lab,” said Patty Graham, R.N., Clinical Nurse Specialist at UCSD Medical Center. “The use of this protocol and a finely tuned team approach meant that Mr. Murray got to go home alive and well.”
One week after his successful treatment at UCSD Medical Center, Murray returned to work at the University of Alabama. He hopes to raise awareness of this life-saving technique in his hometown of Birmingham and plans to become recertified in CPR.
According to the American Heart Association, cardiac arrest carries a greater than 90% mortality rate leading to over 300,000 deaths in the United States each year. About two thirds of unexpected cardiac deaths occur without prior recognition of cardiac disease.
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