What a Cool thing to do for people!
Email
PrintIn October of 2007, Bellin Hospital began offering therapeutic hypothermia to patients who had suffered cardiac arrest. This "cool" new therapy, actually cools the body temperature, and helps to save your brain if you have had a heart attack.
The following article written by
Sarah R. Brandt, RN, CCRN, CFRN
Bellin Advanced Care Department
Unfortunately, the chances of surviving a cardiac arrest are less than 15%. American Heart Association basic and advanced life support has helped to increase that percentage over the last few decades, but many of those that survive may be plagued with life long mental disability. This is caused by the lack of oxygen to their brain during the cardiac arrest or “code”. There is a chance that they may never be able to talk, work, or walk again.
But there is good news! An exciting new therapy has been started at Bellin Hospital. It may improve neurological (brain function) outcomes by nearly 30%. We call it Therapeutic Hypothermia. Therapeutic Hypothermia is indicated for those who have had their heart stop, but with CPR and other life saving processes, have regained a pulse.
Therapeutic Hypothermia is started after a patient is successfully resuscitated (meaning that their heart is beating again), but does not regain consciousness (they don’t wake up). The process starts by cooling the patient’s body temperature to 32 degrees Celsius (91.6 degrees Fahrenheit) for 24 hours. Normal body temperature is 37 degrees Celsius (98.6 degrees Fahrenheit). The cooling process is started as soon as possible after the victims pulse returns, and the patient is slowly rewarmed after the 24 hour period of cooling has elapsed.
Why does this help? The cooling process protects the brain. While the exact mechanism of protection has yet to be understood, there are two main theories. Induction of cold body temperature slows down the metabolic state of the brain and body decreasing its physical stress. Also, the colder body temperature prevents the formation of free radicals (chemicals produced as a response to injury within the body) which can lead to swelling of the brain and increased brain injury.
While undergoing the process, many other components of care are happening. The patient must be admitted to an intensive care area such as the Advanced Care Department at Bellin Hospital. Patients are sedated and given medications to prevent shivering. Shivering is the body’s way of warming itself. A ventilator (breathing machine) helps the patient breathe while receiving these medicines. Also, many lab tests are necessary to ensure the body’s electrolytes are being maintained in the cold environment.
Bellin Health System has purchased the Alsius CoolGard system to assist in achieving a quick cool down and consistent temperature maintenance. The system works by circulating cool solution inside a closed catheter which is placed in the body by a physician. With the Alsius CoolGard, nurses and doctors are able to cool the patient to the desired temperature in 2 to 3 hours. Current research says the faster the goal cooling temperature is reached, the better outcome is achieved.
After cooling and rewarming phases are complete, the patient is taken off the sedation medications to evaluate their ability to move, think, and communicate. While the therapy may not be able to help every patient, Bellin patient’s receiving this cooling therapy may have up to 30% better chance of less brain damage.
Kristina Hilgendorf, a teacher, was one of the first patients treated with this therapy at Bellin Hospital this February. She collapsed while working. When the paramedics arrived, they found her heart had stopped and they preformed CPR while rushing her to Bellin. With the hard work of the paramedics who brought her to the hospital and the nurses and doctors in the Emergency Department, Hilgendorf’s pulse returned….. but she did not wake up. In situations like this, the outlook is often grim. Her chances of regaining normal brain function did not look good. She was brought to the Advanced Care Department and the cooling process began.
After cooling Hilgendorf for 24 hours, she was warmed and the sedation medications were turned off and the breathing machine was removed. She was awake and immediately able to speak. Later that day, she was sitting up and moving around.
Bellin Hospital and the nurses and doctors in the Advanced Care Department are happy to be able to provide Therapeutic Hypothermia for cardiac arrest victims. It will give patients an improved chance of returning to their lives, like Kristina Hilgendorf.
