Therapeutic hypothermia dramatically improves the chances of recovery among those who suffer from cardiac arrest, according to Dr. George A. Lopez, assistant professor of neurology at Baylor College of Medicine in Houston. Lowering the body's temperature after a cardiac arrest dramatically increases the chances for surviving and improves the neurological outcome.
Traditionally, survivors of sudden cardiac death who are resuscitated but do not regain consciousness rarely wake up again. Now, however, physicians have a potential solution.
"The tide is changing where before we wouldn't be able to do anything," said Lopez, a neurologist at The Methodist Hospital. "Now we're at the other end of the spectrum where we actually have a treatment to protect their brain, help them survive and improve their neurological outcome."
Lopez has investigated the effectiveness of two different cooling methods that lower the body's temperature from 98.6°F to 89°F without imposing severe risks. Lopez has had success using either a catheter, which chills blood internally through a large vein in the leg or chest, or a specially designed body wrap that circulates cold water on top of the skin. Both techniques temporarily reduce the brain's oxygen needs.
Hypothermia may also be applied in instances of traumatic brain injury and liver failure. In the latter case, the liver is hampered in its role of cleansing toxins that can travel to the brain and cause it to swell. Hypothermia has been shown to decrease the amount of swelling and increase the chance of surviving until the liver regenerates and heals or until the patient receives a new transplanted liver.
Although first used therapeutically in the 1950s for special surgical procedures, hypothermia has recently been re-investigated as a neuroprotectant - but in very few hospitals around the world. Its limited use derives from lack of knowledge of the potential treatment's benefits.
"My dream is to have this treatment offered on a much wider basis than is currently being offered," Lopez said. "Hypothermia should be a standard of care in patients who have survived sudden cardiac death."
In an effort to spread the word, Lopez has organized an upcoming symposium, "Hypothermia in Clinical Practice: From Bench to Bedside - Applications for Emergency Medicine, Neurology, Cardiology, Neurosurgery, and the ICU." It will take place on Sept. 11 at the Warwick Hotel in Houston.
The symposium will attract doctors, nurses, and other health care professionals from several areas of medicine with the intent of disseminating the positive attributes of therapeutic hypothermia. "Hypothermia is useful in a variety of different medical specialties, so the seminar is intended for a fairly wide audience," Lopez said.
Lopez is also working directly with The Methodist Hospital to implement hypothermia in cases of acute ischemic stroke, in which blood supply to the brain is decreased or blocked. He is currently participating in a national study, funded by the National Institutes of Health, to conduct further research on hypothermia's applications for stroke victims.