Therapeutic Hypothermia Saves Comatose Cardiac Arrest Patients|
ARLINGTON, Texas — When 21-year-old Austin Miller was accidently kneed in the chest during a softball game, his heart stopped.
Paramedics and clinicians in the emergency room shocked him with a defibrillator 15 times, trying to regain a normal heartbeat for 40 minutes. According to his doctor, Gary Jones, M.D., pulmonologist on the medical staff of Texas Health Harris Methodist Hospital Hurst-Euless-Bedford, the lack of oxygen to his brain should have killed him or left him in a vegetative state.
But an emerging treatment called therapeutic hypothermia — literally chilling the patient’s body — helped Miller fully recover.
Therapeutic hypothermia has become the standard of care for cardiac arrest patients who have regained a pulse but remain comatose at Texas Health HEB and Texas Health Arlington Memorial Hospital. Studies have shown the treatment helps improve survival rates and prevent brain injury.
“I’ve seen patients who were knocking on death’s door, brain-dead by any neurologist’s standards, become alert and awake 36 hours after the therapeutic hypothermia treatment,” said Yama Amin, M.D., emergency physician on the medical staff at Texas Health Arlington Memorial. “It’s pretty amazing.”
Very few patients survive cardiac arrest, but those that do begin to experience brain damage due to lack of blood flow in just four to six minutes, according to the American Heart Association. Only a third of patients who experience cardiac arrest outside of a hospital will recover with normal neurological function.
The goal of therapeutic hypothermia is to slow down the metabolic processes and demands of the brain to prevent swelling, Amin said. This decreases the brain’s need for oxygen and can reduce or minimize injury. The patient is chilled to 91 degrees Fahrenheit using cooling blankets and an IV with iced saline. Twenty-four hours later, the patient is slowly re-warmed.
In 2005, the American Heart Association endorsed therapeutic hypothermia as a resuscitation therapy for comatose cardiac arrest survivors. Texas Health HEB adopted the protocol in 2006 and shared it with Texas Health Arlington Memorial.
“Nothing has been as revolutionary as therapeutic hypothermia for cardiac arrest patient care over the past decade,” Amin said.
Miller’s doctors at Texas Health HEB call him a “miracle of modern medicine.” He is currently in rehabilitation and re-learning small tasks like eating and writing.
“I’m only 21 years old and I almost died,” Miller said. “It puts things in perspective a little bit — how simple but yet how difficult life can be, and how it can change in a snap.”
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