New York City is conducting a three-year study, training its paramedics in a relatively new cooling therapy that has been proven to increase the chances for cardiac arrest patients to survive and avoid brain damage.
The treatment is technically known as therapeutic hypothermia, and it involves lowering a patient’s body temperature in order to slow the brain’s demand for oxygen and prevent damage to cells. About 20 hospitals in the city began trying it, that figure is now up to 43. At a scene of an emergency, what's involved is cold packs, injections of cold saline solution into a vein or a bone, along with other more sophisticated equipment. The goal is to lower the patient's body temperature by about six degrees for 24 hours.
The New York Times
reports that since the pilot program began, about 2,600 cardiac patients were taken to hospitals as potential recipients of the treatment. City officials say that survival rates for those patients increased 20 percent last year compared with 2008, a change they attribute to the cooling therapy. City Fire Commissioner Salvatore J. Cassano likes the new treatment
“It brings your body out of that panic mode, and it actually reduces your body’s need for blood. That buys us time.”
New York City is now entering the second phase of its Project Hypothermia. New York City Mayor Mike Bloomberg,
in a press release says the project now moves into Phase II, with paramedics being taught to give the treatment to patients inside ambulances.
Fire Officials say city paramedics respond to about 15,000 calls each year from people with heart attack symptoms, and half result in cardiac arrest.
New York is one of the first cities nationwide to use therapeutic hypothermia during cardiac arrest. It is more commonly used after a patient has been revived, to prevent secondary injuries that often occur when the blood rushes back into the heart.
Dr. John Freese, medical director of the Emergency Medical Service for the Fire Department, said the department has been focused on improving cardiac arrest survival rates for the last seven years. Studies reveal that the only notable side effect from cooling has been a mild fluid buildup in the lungs, which can be avoided by careful monitoring of patients.
Zeynep Sumer, vice president for regulatory and professional affairs for the Greater New York Hospital Association, says she pleased by the results from all quarters.
"The participating hospitals have been “extremely encouraged by the results so far. We’re seeing a lot of interest in the project from hospitals outside of New York City.”
Upstate New York areas like Buffalo and Albany are also participating in the demonstration project, and the State Department of Health is waiting for data on its success there. And the treatment is already in use in several cities, including Miami, Boston and Seattle, as well as in London and Vienna.
Dr. Stephan Mayer, who is chief of the neurological intensive care unit at NewYork-Presbyterian/Columbia University Medical Center in Manhattan, first brought the idea for this project to the hospital association. He has been a longtime believer in cooling therapy, and has been a consultant to two companies that provide equipment used in its treatment. He has since divested his holdings in those companies.