Hypothermia proves successful in younger cardiac patients too

Apr 03, 2011

Young adult patients with genetic heart diseases, such as hypertrophic cardiomyopathy (HCM), substantially benefitted from therapeutic hypothermia, which could further extend the role for this treatment strategy in new patient populations, according to a scientific presentation at the American College of Cardiology (ACC) Scientific Sessions in New Orleans, April 1-3.

In patients with HCM, despite rapid cardiopulmonary resuscitation (CPR) with defibrillation, survival following out-of-hospital cardiac arrest has been particularly unfavorable, explained the study authors.

"Therapeutic is an effective survival and neuroprotective treatment strategy increasingly employed in unconscious patients with out-of-hospital cardiac arrest and restored spontaneous circulation," explained the study's senior author Barry J. Maron, MD, director of the Hypertrophic Center at the Minneapolis Heart InstituteFoundation in Minneapolis. "However, there are no reports of therapeutic hypothermia employed in the patients with HCM."

Retrospectively examining patient records at Minneapolis Heart Institute® at Abbott Northwestern Hospital in Minneapolis and Tufts Medical Center in Boston, the researchers found that seven young, asymptomatic patients with HCM (mean age 43), unexpectedly incurred cardiac arrest within a 46-month period, and survived after receiving therapeutic hypothermia.

"This success rate was unexpectedly high, especially given the experience with HCM and the CPR/defibrillation era" Maron said.

The researchers found that the response was prompt at both facilities, including: collapse to resuscitation within three minutes; transport from collapse to the hospital for initiation of cooling (mean of 172 minutes); and the initial Glasgow coma score was 3 in each patient. Therapeutic hypothermia was administered with rapid cooling to 31° to 33° Celsius core body temperature for 24-29 hours, with intact cardiac function and complete restoration of normal neural, cerebral and cognitive functions six to 52 months after the event.

While several reversible complications occurred, each patient survived with neuroprotection, preserved cognitive function and intact cardiac function six to 52 months after their event, the researchers reported.

Hypothermia was successful despite HCM risk factors, including marked left ventricular wall thickness of more than 20 mm in six patients, outflow obstruction, asystole initially in one patient and a long delay to cooling of more than four hours in one patient.

"These findings support the idea of more widespread availability and utilization of therapeutic hypothermia, due to its successful outcomes with out-of-hospital ," Maron concluded. "Previous research of therapeutic hypothermia has focused on older patient populations, but this study proves the worth of this technique in younger patients with genetic disease."

Explore further: Allergan to cut 1,500 employees in restructuring (Update)

Provided by Minneapolis Heart Institute Foundation

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Post-cardiac arrest care key to survival

Oct 23, 2008

The urgent need for treatment doesn't end when a person regains a pulse after suffering sudden cardiac arrest — healthcare providers need to move quickly into post-cardiac arrest care to keep a person alive and ensure the ...

Cooling may benefit children after cardiac arrest

Dec 03, 2009

When the heart is stopped and restarted, the patient's life may be saved but their brain is often permanently damaged. Therapeutic hypothermia, a treatment in which the patient's body temperature is lowered and maintained ...

Cooling may benefit children after cardiac arrest

Nov 09, 2010

When the heart is stopped and restarted, the patient's life may be saved but the brain is often permanently damaged. Therapeutic hypothermia, a treatment in which the patient's body temperature is lowered and maintained several ...

Recommended for you

British Lords hold ten-hour debate on assisted dying

Jul 19, 2014

Members of Britain's unelected House of Lords spent almost ten hours on Friday discussing whether to legalise assisted dying, in an often emotional debate putting the question back on the agenda, if not on the statute books.

AbbVie, Shire agree on $55B combination

Jul 18, 2014

The drugmaker AbbVie has reached a deal worth roughly $55 billion to combine with British counterpart Shire and become the latest U.S. company to seek an overseas haven from tax rates back home.

Safety problems at US germ labs acknowledged

Jul 16, 2014

(AP)—The director of the U.S. Centers for Disease Control and Prevention acknowledged Wednesday that systemic safety problems have for years plagued federal public health laboratories that handle dangerous ...

User comments : 0