SEATTLE -- Hospitals commonly cool the body temperature of people resuscitated by CPR once they get to the Emergency Room to reduce inflammation and brain damage. Researchers in King County now want to know if the survival rate would improve if they could cool people BEFORE they even get to the hospital.
University of Washington cardiologist Dr. Francis Kim is in the middle of a 3 year study to see if starting hypothermia in the field can improve survival rates. Medics do this by infusing the resuscitated person with two liters of chlled saline solution. It brings about a mild hypothermia, a body temperature of about 90 to 92 degrees (98.6 degrees Farenheit is considered "normal.") Medics also administer a muscle relaxant to prevent shivering.
"When there's no blood flow and no oxygen, those blood cells start to die and cooling kind of protects the brain and allows it to recover," said Kim. Kim and his colleagues have enrolled about 800 participants so far. The goal is to enroll 1,364. They must be people over 18 years of age who actually die and are revived by CPR and electric shock. Half are given the cold saline in the field, the other half are not.
Kim says if the study shows the therapy increases survival rates, it could be adopted as a national standard. If not, it wouldn't be used.
Back in January, 62 year old Mike Messmer suffered cardiac arrest. His daughter started CPR. When Redmond medics arrived, they administered electric shock to get his heart beating. They then called Harborview to ask if they should fill Messmer's veins with cold saline, inducing hypothermia. They got the green light and infusion began as the medic unit sped to Overlake Medical Center.
"It's as soon as we can get it started," says Seattle Fire Captain Jonathan Larsen. Medic units are equipped with a refrigerator that keeps two liters of saline icy cold, about 4 degrees Celsius. "It may be in your house, it may be in your office, it may be in the back of the unit on the way to the hospital. But the sooner we start it, the better," Larsen said.
There are side effects to the saline therapy such as a higher risk of infection and fluid build up in the lungs, but Dr. Kim says they have not seen an increase in those side effects so far.
Mike Messmer marvels at how good he's feeling six weeks after flat-lining, He says he's feeling fit and even got his driver's license back. "The way things turned out, well, here I am talking to you! I was dead before this, you know?"