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Cool a Brain, Save a Life

Brain Chilling Raises Odds That Cardiac Arrest Sufferers Will Survive With Brain Function
By
WebMD Health News
Reviewed by Louise Chang, MD

Nov. 16, 2009 (Orlando, Fla.) -- Chilling the brains of people in cardiac arrest as they are rushed to the hospital improves the chances they will survive -- and without brain damage, researchers report.

In cardiac arrest, the heart stops beating, cutting off the blood supply to the body and brain. Even if a patient can be resuscitated, brain damage often results.

But several years ago, researchers found that lowering the body temperature of a newly revived cardiac arrest patient in the hospital can make a big difference.

The new approach, already in use in Europe, extends the technique to people who suffer cardiac arrest outside the hospital.

"Cooling the brain fast and really early is critical to success," says Maaret Castrén, MD, of the Karolinska Institute in Stockholm.

In the new study, 37% of 182 patients treated with the portable device during resuscitation had good neurological function when discharged from the hospital, compared with 18% who received standard resuscitation.

Also, 47% of patients who had their brains cooled during resuscitation survived to hospital discharge, compared with 31% who were resuscitated without cooling.

In patients in whom CPR was started within 10 minutes of cardiac arrest, the benefits of cooling were even greater, Castrén tells WebMD.

There were 18 adverse reactions related to the treatment, including three nosebleeds and 13 nasal discolorations. In all patients who survived, the color returned to normal.

Serious adverse events, including seizure and repeat cardiac arrest, occurred in seven patients treated with the device and 14 patients who received CPR alone.

The research was presented at the American Heart Association meeting.

Faster Cooling Method

Cooling blankets and pads are used to reduce the body temperature of cardiac arrest patients. But those methods are bulky and take time to start working, says Denise Barbut, MD, chairman of BeneChill, which makes the brain-cooling device and funded the study.

The new device, called RhinoChill, is noninvasive and introduces coolant through nasal prongs. Since it is battery powered and does not require refrigeration, emergency medical technicians can use it in the field while the patient is getting CPR.

Michael Sayre, MD, a cardiologist at Ohio State University Medical Center in Columbus, is cautiously optimistic.

"Cardiac arrest is extremely common," he says. Fewer than 20,000 of the 200,000 Americans who have a cardiac arrest outside the hospital every year survive, so if these results pan out, "this could be really important."

But, he cautions, the findings need to be replicated before its use will become widespread.

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