Even A Little Cooling Helps After Cardiac Arrest

As many as 400,000 people in North America suffer sudden cardiac arrest. Only 30% have their hearts restarted, and only about 6% survive to hospital discharge. Once the heart is restarted, a significant factor for subsequent death is brain injury.

In a paper presented at the 2006 Society for Academic Emergency Medicine Annual Meeting, May 18-21, in San Francisco, investigators from the University of Pittsburgh discussed the results of an animal model study to evaluate whether the simpler procedure might provide equivalent benefit.

Cooling a person by 3-4 篊 during the first day after resuscitation has been demonstrated to improve the odds of a good recovery, but few patients receive this therapy. There may be fear of complications or logistical difficulties in carrying out the therapy in most hospitals. Practically speaking, cooling a person by 2 篊 is more manageable than cooling by 4 篊.

By using rats that had been anesthetized and subjected to cardiac arrest, the severity and duration of brain injury observed in humans was replicated. The rats were resuscitated with chest compression and epinephrine, and cranial temperatures were monitored and controlled at 37 篊 (normal), 35 篊 (2 篊 cooling) and 33 篊 (4 篊 cooling). Neurological scores were measured daily, and at the end of 14 days, their brains were examined for damage.

Rats cooled to 33 篊 did best, as measured by neurological scores, median days to return to normal, and neuron density in the hippocampus. The 35篊 group had somewhat lower results while the normal group had the worst outcomes. Overall, the benefit of cooling only 2 篊 was similar to 4 篊 cooling. These results suggest that even modest cooling of the brain might have significant benefit to humans who have been resuscitated after cardiac arrest.

The presentation is entitled 揅omparison of 33篊 and 35篊 hypothermia after cardiac arrest?by Eric S Logue, Melissa R McMichael, and Clifton W Callaway MD. This paper will be presented at the 2006 SAEM Annual Meeting, May 18-21, 2006, San Francisco, CA on Thursday, May 18, in the Plenary Session beginning at 8:00 AM in Salon 9 of the San Francisco Marriott. Abstracts of the papers presented are published in the May issue of the official journal of the SAEM, Academic Emergency Medicine.

About The Society for Academic Emergency Medicine
saem.org

The Society for Academic Emergency Medicine (SAEM) is a national non-profit organization of over 6,000 academic emergency physicians, emergency medicine residents and medical students. SAEM's mission is to improve patient care by advancing research and education in emergency medicine. SAEM's vision is to promote ready access to quality emergency care for all patients, to advance emergency medicine as an academic and clinical discipline, and to maintain the highest professional standards as clinicians, teachers, and researchers. The SAEM Annual Meeting attracts approximately 2,000 medical students, residents and academic emergency physicians. It provides the largest forum for the presentation of original research in the specialty of Emergency Medicine.

About Academic Emergency Medicine
aemj.org

The SAEM's official journal, Academic Emergency Medicine, is published by Elsevier. Established in 1994, Academic Emergency Medicine is a monthly peer-reviewed journal that publishes material relevant to the practice, education, and investigation of emergency medicine, and reaches a wide audience of emergency care practitioners and educators. Each issue contains a broad range of topics relevant to the improvement of emergency, urgent or critical care of the acutely ill or injured patient. Regular features include original research, preliminary reports, education & practice and annotated literature.

About Elsevier
elsevier.com

Elsevier is a world-leading publisher of scientific, technical and medical information products and services. Working in partnership with the global science and health communities, Elsevier's 7,000 employees in over 70 offices worldwide publish more than 2,000 journals and 1,900 new books per year, in addition to offering a suite of innovative electronic products, such as ScienceDirect (sciencedirect.com), MD Consult (mdconsult.com), Scopus (info.scopus.com), bibliographic databases, and online reference works.
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Even A Little Cooling Helps After Cardiac Arrest