Normally it’s not safe when your body temperature drops to 91 degrees. But for sudden cardiac arrest survivor Rita West, of Hinsdale, rapidly cooling her body is the reason she is alive today.
West was treated at Adventist Hinsdale Hospital using an induced hypothermic coma, which uses special equipment and procedures to cool a patient’s body to slow metabolism and reduce the brain’s need for oxygen. This halts muscle and tissue damage as well as preserves the patient’s neurological function during sudden cardiac arrest.
“Hypothermia basically shuts down the brain so it’s not demanding as much energy,” said Dr. Duane Follman, an interventional cardiologist who treated West and two other patients using induced hypothermic coma. “During cardiac arrest, it’s vital to protect the brain.”
A total of eight patients have been treated at Adventist Hinsdale Hospital since the hospital developed this protocol for sudden cardiac arrest patients about nine months ago. In that time, the hospital has trained more than 120 nurses – all of the nurses who work in the emergency department, intensive care unit, coronary care unit and neuro intensive care unit – on how to administer the innovative procedure.
West was making dinner on Valentine’s Day when she suddenly collapsed in her kitchen. Her husband called 911 and Tri-State ambulance rushed her to Adventist Hinsdale Hospital’s emergency room. Because emergency medical technicians properly assessed West’s condition in the ambulance and communicated it to the hospital team, hospital staff were able to start the hypothermia treatment within minutes of her arrival. Patients are put on a ventilator during the cooling process.
Hypothermia patients typically are slowly warmed up to normal body temperature 24 to 48 hours after the treatment is initiated. But when hospital staff started to slowly warm up West, she experienced a second episode of cardiac arrest, which is the sudden, abrupt loss of heart function. Most cardiac arrests that lead to sudden death occur when the electrical impulses in the diseased heart become rapid or chaotic or both. This irregular heart rhythm, or arrhythmia, causes the heart to suddenly stop beating. If untreated, brain death and permanent death start to occur in just four to six minutes.
West underwent a second round of hypothermia and was taken to the cardiac catheterization laboratory, where her blocked artery was opened and a balloon pump inserted. A temporary pacemaker and dialysis catheter also were inserted. In addition to Follman, West’s care team included nephrologist Dr. May Chow, neurologist Dr. Helge Frank, pulmonologist Dr. Vasantha Samala and cardiac electrophysiologist Dr. Andrew Lawrence.
Discharged March 8, West is undergoing physical therapy in her home three days a week. She expects to start cardiac rehabilitation in early April. An active 63-year-old who plays tennis regularly and has no history of heart disease, West considers herself “so very lucky” that she was able to come home after suffering two episodes of sudden cardiac arrest in a short period of time. For cardiac arrest that occurs outside of a hospital, the national survival rate is a mere 6 percent.
“There was a time when the doctors didn’t know if I’d survive, or that if I did survive, I’d be OK,” West said. “But I’ve always been a fighter when it comes to my medical history. I’m a survivor.”
In February alone, three Adventist Hinsdale Hospital patients – including West – were treated using induced hypothermia. Adventist Hinsdale Hospital borrowed a cooling machine from one of its sister hospitals, Adventist GlenOaks Hospital, in order to treat two patients simultaneously. The machine injects chilled saline intravenously. If the machine is not available, a patient can be cooled using old-fashioned icepacks.
Hypothermia therapy has for years been used in the operating room when doctors want to slowly reduce a patient’s need for oxygenated blood during heart and other surgeries. But the use of induced hypothermia during cardiac arrest is not widespread – it is used in only about 20 percent of U.S. hospitals, despite studies detailing the benefits in the New England Journal of Medicine in 2002 and international recommendations in 2005 urging the treatment. The treatment also has been a part of the American Heart Association’s lifesaving guidelines for cardiac arrest care for the past five years.
Dr. Scott Guth, an emergency room physician who helped develop the hypothermia protocol, said it’s “absolutely amazing to watch a sudden cardiac arrest patient walk out of the hospital and say ‘thank you’” after undergoing the treatment.
Adventist Hinsdale Hospital nurse educator Maria Suvacarov, who arranged training sessions for the hospital’s nursing staff, said nurses – especially those who have witnessed extremely sick patients like West get discharged from the hospital with no lasting damage – are champions of the procedure.
“Our nurses have truly embraced hypothermia therapy as a treatment for sudden cardiac arrest,” Suvacarov said. “They’ve become believers.”
That includes one of West’s nurses, Debbie Green, who works in the coronary care unit (CCU).
“We have seen excellent results from it. Patients who you think are not going to come out of it – they recover,” Green said. “It’s remarkable.”