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Friday, October 19, 2007
After cardiac arrest, the risk of irreversible brain damage and death increases with every passing minute, but the Massachusetts General Hospital Heart Center is using a new technology to improve the chances of recovery.
That technique is to initiate therapeutic hypothermia using a safer and more effective system to cool the body. In therapeutic hypothermia – also known as "body cooling" – a team of cardiologists, neurologists and nurses carefully lowers the patient’s body temperature to between 89 and 93 degrees Fahrenheit, which helps optimize the brain’s chances of recovery. Of the three Boston hospitals now using this technology, Mass General Hospital was the first to implement the treatment. Improved TechnologyFor decades, therapeutic hypothermia has been used as a way to protect the brain after certain traumas, and studies have shown that lowering brain temperature in comatose survivors of cardiac arrests could lead to better neurological outcomes. Traditional cooling has been achieved by using cooling blankets, bags of ice, cold saline infusions or ice baths; however, these methods were labor intensive, inconsistent, and carried potential side effects.Now new technology, called the Artic Sun Temperature Management System, uses water- and gel-filled pads that are applied directly to the patient’s thighs and chest. Temperature-controlled water circulates to cool or rewarm the patient. The system is noninvasive, skin-safe and provides excellent temperature control."For a patient to benefit from the protocol, cooling must begin within six hours of the cardiac arrest," says Colleen Snydeman, RN, nursing director of Mass General Hospital's Cardiac Intensive Care Unit (CICU). “Nurses play a vital role in helping to identify appropriate patients, so we can meet that window of opportunity and give patients every chance to recover.Recovering From Cardiac ArrestClaire Simmons is one patient who has experienced the benefits of this lifesaving technology. After suffering a cardiac arrest and being transported to Massachusetts General Hospital, Simmons’ body was cooled to the point of hypothermia over the course of eight hours and kept there for 24 hours.After three days, Simmons began to respond. "It was wonderful to see her recover so quickly and completely from such a potentially devastating event," says Claudia Chae, MD, a cardiologist at the Massachusetts General Hospital Heart Center. Remarkably, the only neurological evidence of her trauma was a loss of memory around the time leading up to her cardiac arrest."I don’t really feel different. That’s the point. My brain is OK," says Simmons. "I feel I’m 100 percent who I was before."
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