Cardiac arrest occurs when a disruption of the heart’s normal rhythm causes the heart to stop beating. When it happens somewhere other than in a hospital, fewer than 10% of victims survive. Yet even when cardiac arrest happens inside a hospital, where medical resources are immediately available, the survival rate is still just 22%, a dismal statistic…and many patients who do live suffer irreversible brain damage from oxygen deprivation.

There’s a treatment for cardiac arrest called therapeutic hypothermia that can save lives and protect against brain damage. But: Hospitals don’t often do it! Here’s what you need to know about this vital treatment.

GETTING WITH THE PROGRAM…OR NOT

Back in 2002, several studies showed that lowering body temperature to between 89.6° and 93.2°F (32° to 34°C) could significantly reduce brain damage and improve survival rates for patients who experienced cardiac arrest away from a hospital setting. Because of those studies, the International Liaison Committee on Resuscitation issued guidelines recommending therapeutic hypothermia for many specific types of out-of-hospital cardiac arrest. Because there was no data on how well the therapy worked for patients who were in the hospital when cardiac arrest occurred, the guidelines suggested that therapeutic hypothermia be considered in such cases.

To see how often this life-saving, brain-saving treatment was being used among hospitalized patients who suffered cardiac arrest, researchers recently reviewed records from the 538 hospitals that participate in the American Heart Association’s voluntary Get With the Guidelines?Resuscitation registry. And what they found was very discouraging…

  • Over the course of the study period (from 2003 to 2009), nearly 67,500 hospitalized patients were eligible for therapeutic hypothermia—but only 1,367 actually received the cooling treatment. That’s a paltry 2%.
  • Even among patients who did get therapeutic hypothermia, for more than 44% it was not possible—because of extenuating conditions, such as the patient having a fever—to cool the patient to the right temperature range.
  • 48% of the hospitals did not try the treatment even once over the seven-year period.
  • The only bright sign was that use of hypothermia did rise over the course of the study, from a rate of 0.7% of in-hospital cardiac arrest patients in 2003 to 3.3% in 2009. And most hospitals today do have the capability to provide this type of therapy. Still, there’s obviously a long way to go until the treatment becomes the norm and not the exception.

HOW COOLING SAFEGUARDS HEALTH

Researchers believe that the cooling treatment slows the body’s metabolism, limiting the production of free radicals and the other deleterious effects that oxygen deprivation has on all organ systems, especially the brain, after cardiac arrest.

Hypothermia is induced either by surface cooling or endovascular cooling. Surface cooling can include lowering the room air temperature and/or using cooling blankets and ice packs. Endovascular cooling involves inserting a catheter into a major vein in the body, then pumping chilled fluid (39.2°F or 4°C) into the catheter. The fluid does not leave the catheter, but the blood is cooled as it passes by the catheter. This method is faster and more precise than surface cooling. Patients are unconscious during hypothermia treatment, so they are not uncomfortable.

How to save a life: In the event that you witness a friend or loved one suffering cardiac arrest away from a hospital, your first step is to call 911. Then, unless an automated external defibrillator is available, immediately begin CPR and don’t stop until emergency responders arrive and take over. Remember that CPR is now hands-only—hard and fast (click here for more on the right way to do CPR). When you and the patient reach the hospital—or if a loved one experiences cardiac arrest while already in the hospital—ask the attending physician about initiating therapeutic hypothermia as soon as possible. Though not all cardiac arrest patients are candidates for the treatment, in many cases this “cold therapy” may make the difference between life and death.