Fighting Sudden Cardiac Arrest with a Chill

The chances of surviving SCA can be as little as 3 percent, depending on your location and access to EMS. In most cases early defibrillation is the only treatment.

Even if an individual survives a trip to the hospital, their bodies are still in a very critical state. “After we start the heart again, about 60 per cent of people who get admitted to hospital will end up dying as a complication of the cardiac arrest. That’s because other important organs are injured when blood flow stops,” says Steven Brooks, at Toronto’s Sunnybrook Hospital.

For this reason, two hospitals in Toronto are experimenting with therapeutic hypothermia, a deep freeze medical treatment aimed at increasing a patient’s chance of retaining neurological function after suffering SCA.

The goal is to lower the patients’ temperature by roughly five degrees Celsius for a 24-hour period. The cooling is achieved through a combination of ice packs placed around major arteries, a chilled saline solution and temperature controlled blankets.

Dr. Brooks said this cooling treatment is significantly more effective than some other traditional treatments.

One study published in 2002, in the New England Journal of Medicine has demonstrated improved neurological outcomes for the use of therapeutic hypothermia on survivors of cardiac arrest. The study shows a decrease in the mortality rate with patients who have been cooled (41 percent) compared to patients who were not cooled (55 percent).

Despite the positive results, therapeutic hypothermia currently still isn’t a very popular option in Canadian hospitals. It is fairly easy to establish, but takes a very coordinated effort to make it happen.

Fortunately, in Dr. Brooks’ opinion, the effort is well worth it. He has created a dedicated on-call Post Arrest Consult Team (PACT) that will be able to manage therapeutic hypothermia services. Eligible patients who are brought into both Sunnybrook and St. Michael’s hospitals in Toronto will receive a potentially lifesaving deep freeze.

Kelvin Au is one individual who credits therapeutic hypothermia with his survival. In 2009, the 33-year-old was rushed to a hospital after collapsing on a basketball court. The doctors were able to re-start his heart, but he did not regain consciousness. Afraid that his neurological functions were deteriorating, the doctors transferred him to St. Michaels for experimental hypothermia treatment. At that time very few were practicing therapeutic hypothermia at St. Michaels, and the PACT team had not yet been created.

“The doctors had been pessimistic, but they said this cold treatment was the best shot at his recovery,” said his wife, Liz Au.

The treatment ended up saving Mr. Au’s life, but he still suffers side effects of his collapse. “This is definitely one of the things that saved my life,” Mr. Au said. “I now have my life almost back to normal, but I still can’t remember about two weeks of my life around when the heart attack happened and I have short-term amnesia.”

With the recent successes, Dr. Brooks hopes therapeutic hypothermia will eventually lead to application at more hospitals throughout Canada.

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