Cooling Therapy Benefits Cardiac Arrest Patients at Risk for Brain Injury
Wendy Schneider is living proof of the value of cooling technology used after cardiac arrest to decrease or eliminate brain damage. After suffering chest pain and eventually passing out, the 44-year-old’s heart stopped while she was en route to a community hospital. Though stabilized, her heart arrested several times, repeatedly preventing oxygen from reaching her brain. She was quickly transferred to Strong Memorial Hospital, where the Cardiac Catheterization team treated her, including using the Medivance Arctic Sun noninvasive cooling system.
Schneider remembers nothing of that time, but was told by her loved ones when she awoke that she was a “miracle patient” who, despite doctor’s warnings of potential brain damage and paralysis, beat the odds with help of Arctic Sun.
Strong was the first hospital in upstate New York to acquire the technology, immediately incorporating the practice into its patient response protocol. The cooling therapy has been the standard of care at URMC for more than five years, with about 50 patients per year receiving the treatment.
Resulting in dramatic patient outcomes, the therapy involves a water circulating system that lowers a patient’s inner core temperature in hopes of stemming any brain damage resulting from loss of blood and oxygen flow to the brain. Pads adhere to the skin to circulate the cooled water at the points of the thighs, trunk and back, and a computer monitors the patient’s temperature and automatically cools or warms the circulating water as needed. A patient’s core temperature can usually be decreased to the correct zone within two hours. After 24 hours, the body is gradually warmed.
“By bringing down the inner body’s core temperature to about 92 degrees Fahrenheit, we are able to slow down metabolism, inflammation and the release of harmful neurotransmitters, giving patients a chance at a full and meaningful recovery after cardiac arrest,” said Scott Burgin, M.D., associate professor in the Department of Neurology.
More than three-quarters of patients treated have structural coronary disease and require cardiac treatment, such as angioplasty or CABG, according to Frederick S. Ling, M.D., associate professor in the Department of Medicine and director of the Cardiac Catheterization Laboratory.
Cardiac specialists at Strong eventually implanted ventricular assist devices to help Schneider’s weakened heart continue to work. Her recovery has been so extraordinary, with her heart becoming healthy again, that her current VAD may be removed in the near future.
URMC is the only regional center that can provide therapeutic cooling therapy with mechanical circulatory support for patients who otherwise may be too sick to undergo cooling. When Schneider’s heart continued to have ventricular fibrillation while on the cooling system, the Artificial Heart Team at URMC was able to continue to provide therapeutic hypothermia while supporting her heart and lung function.
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