state-of-the-art procedure known as therapeutic hypothermia

Specialties Cardiac

Published

USC Marathon Student Better After Cardiac Arrest

...but as Jay reached mile 18, something went terribly wrong. He grabbed his chest and collapsed onto the road. He'd suffered a cardiac arrest.

"When he arrived at the medical center, Jay was in a coma and on a ventilator, in very critical condition," Vespa said. "His brain was certainly at risk for permanent injury due to his heart attack, and we had little time to reverse this effect or even assure that he would live."

Vespa decided to use a state-of-the-art procedure known as therapeutic hypothermia on Jay to maximize his chances for recovery.

"This procedure can be lifesaving in cases like Jay's, where the brain and other organs have been deprived of oxygen for a significant amount of time and the patient is at risk of permanent organ damage or death," Vespa said. "It is not widely used because it requires specialized equipment and trained staff, but it is fully approved."

Vespa and his team inserted a catheter into a large vein and began feeding cooling fluid into Jay's body.

"The process works much like a radiator cools an engine," Vespa said. "The machine runs 24/7 and lowers the body temperature to 89.6 degrees. The cooling protects the body's organs until the brain has time to reboot. We kept Jay chilled for approximately 72 hours, at which time he awoke from his coma. Follow-up tests showed he has no permanent damage to his brain or other organs. He should have a perfect recovery.

Journal of Nursing

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Specializes in Med-Surg /Cardiac Step-Down/CICU/CTICU.

well i didn't keep my patient cooled for 72 hours...i think the whole process is 72 hours cooling...rewarming....maybe it's done differently? anyways he was cooled for 24 hours and then passively warmed. but it was pretty cool...pardon the pun lol....interesting stuff. that's why i love cardiology

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Specializes in CVICU, CCU, Heart Transplant.

In my unit we are using "Arctic Sun" where we lower the pt's temp to 91F. I have yet to take the class, but I agree the whole process is about 72 hours.

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Specializes in ICU, ER, EP,.

I swear this isn't 'state of the art' we were doing it many years ago on regular codes and neuro patients. Now cardiologists are getting in on it too. We use a simple hypothermia H2O filled blanket with core monitoring (rectal probe) and keep their temp 90 to 93 degrees and after set time, rewarm .25 degrees per hour.

Yep, just a cooling blanket, one of our neurologists has always sworn by it. It's certainly not very invasive or costly, so more studies might get more docs on board.

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I swear this isn't 'state of the art' we were doing it many years ago on regular codes and neuro patients. Now cardiologists are getting in on it too. We use a simple hypothermia H2O filled blanket with core monitoring (rectal probe) and keep their temp 90 to 93 degrees and after set time, rewarm .25 degrees per hour.

Yep, just a cooling blanket, one of our neurologists has always sworn by it. It's certainly not very invasive or costly, so more studies might get more docs on board.

Vespa and his team inserted a catheter into a large vein and began feeding cooling fluid into Jay's body.

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In my unit we are using "Arctic Sun" where we lower the pt's temp to 91F. I have yet to take the class, but I agree the whole process is about 72 hours.

when doing this cooling with your product, do you ever see any skin problems for the patient?

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Specializes in Cath Lab/ ICU.
I swear this isn't 'state of the art' we were doing it many years ago on regular codes and neuro patients. Now cardiologists are getting in on it too. We use a simple hypothermia H2O filled blanket with core monitoring (rectal probe) and keep their temp 90 to 93 degrees and after set time, rewarm .25 degrees per hour.

Yep, just a cooling blanket, one of our neurologists has always sworn by it. It's certainly not very invasive or costly, so more studies might get more docs on board.

I agree, not state of the art. Sure, we can get some pretty fancy ways of cooling a pt down, but its pretty basic stuff. Get them cold, keep them cold for 24 hrs, and then cross your fingers for decent brain function as they passively rewarm.

But, honestly, we learned this from mother nature.

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do you have or have you had any skin issues with the pads being on the patients skin?

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do you have any skin issues with surface cooling.

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Specializes in OR, peds, PALS, ICU, camp, school.

I've worked with cooling blankets, Innercool, and Arctic Sun.

Cooling blankets are cheaper but labor intensive- lots of adjusting and monitoring. I don't feel as confident that my temperature changes- hypo- or normo- thermia are working from the core out as I do with the others.

Arctic Sun pads are expensive but it's so nice to be able to set the target temp and let the machine monitor and make the fine tune adjustments in temp. Of course, we're still monitoring that everything is going well and the machine isn't working overhard to compensate for shivering. The pads are a nice thick foam lined with gel adhesive that are gentle on the skin- much like having a big duoderm covering the trunk... but without the wrinkles. They are actually very similar in composition to Duoderm so as not to damage skin when left on for long periods. Arctic Sun did not invent the concept of therapeutic hypothermia but they were the first to design a system just for it and that's ALL the company does (one of their seminar selling points, LOL)

Innercool (I assume what they used in the article) has a pads system that is not as nice as Arctic Sun and also an endovascular system. Both are expensive. I hate to comment on it too much since I think they've changed a lot since I worked with the system. The endovascular system has it's pros and cons- I think it's easier on families since they don't see or feel the source of the chill. It's easier when there is a code brown... uggg... poo under cooling pads... I had a code brown turn into a code blue while cleaning those pads and still worry, LOL. Those were IC pads. I don't like yet another thing invading a central vein. I don't like the whole concept of the chemical cooling fluid bath that the machine end of the line sits in. (I hate dealing with chemicals and one more thing to obtain from store-room. AS just uses plain distilled water) I don't like tracking down the "right" Dr who may insert the cath. AS can be started easily by the nurses.

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