Cool New Cardiac Care

When Pittsfield resident Randy Hodgdon suffered from a heart attack that stopped his heart seven times in May, he became one of the first patients in the state to received therapeutic hypothermia treatment, a process in which the patient’s body temperature is lowered to preserve brain function. Dubbed “Ice Man” by the medical team that treated him at Concord Hospital, Hodgdon is back at home, walking, talking, and getting back into his regular routine despite initial concern over the outcome of the treatment.

While it may sound more mad science than medical, therapeutic hypothermia is one of the latest treatments for cardiac arrest and involves cooling the body to a cool 92 degrees (compared to a normal body temperature of about 98.6 degrees) to reduce the occurrence of brain damage. During cardiac arrest, oxygen cannot reach the brain, resulting in cognitive damage that can be fatal, even if CPR revived the patient and the heart itself was saved. But doctors have found that oxygen loss isn’t the only problem to contend with. After revival, the body’s physical reactions to the trauma of cardiac arrest can worsen neurological damage. Cooling the patient’s body temperature slows the internal processes that can lead to such damage, increasing overall survival rates.

Therapeutic hypothermia is initiated after resuscitation. A breathing tube is inserted and the patient is sedated so that the natural reflex to shiver is eliminated and cannot interfere with treatment. Cooling pads are then applied to 40 percent of the body. The reduced body temperature slows the metabolic processes and allows the brain to remain functional on minimal oxygen, decreasing the potential for cognitive damage.

A study published in the New England Journal of Medicine concluded that therapeutic hypothermia nearly doubled patient survival rates when compared to standard treatment, from 26 to 49 percent. While the method is most effective when implemented as immediately after cardiac arrest as possible, it can be initiated up to six hours after collapse and still benefit the patient. On average, therapeutic hypothermia lasts between 12 and 24 hours. Due to the time and medication the treatment requires, most patients take three days before regaining consciousness.

“We don’t just look to save the heart; we look to save the person,” says Dr. Kenneth Deloge, one of Concord Hospital’s cardiologists. “It has always our goal to provide all that we can to our patients in order to ensure both their survival and an equal if not improved quality of life prior to their heart condition. The addition of induced hypothermia technology helps us further provide our patients with the best possible care.”