Thursday, January 05, 2006

Chill Out

A handful of Minnesota hospitals are now chilling some heart attack patients in an effort partly to protect their brains, a therapy that has produced results one doctor called “breathtaking.”

Take the case of Robert Kempenich, 52, of Little Falls. On Dec. 5, he collapsed at a SuperAmerica store and was rushed to a St. Cloud hospital, where he was hooked up to a machine that lowered his body temperature to 92 degrees.

Under normal circumstances, only about 5 percent of patients who collapse after a sudden heart attack survive. Even if emergency workers get the heart started again, the brain damage is often permanent.

Yet two days after Kempenich collapsed, he awoke from a coma and gave the “thumbs up” sign. His wife, Mary, was there. The sign meant “he knows,” she said. “He knows what he’s doing.”

Less than a week later, Kempenich went home from the hospital. He was back at work at the SuperAmerica last week. His doctors say there are no signs of lasting brain damage.

National guidelines distributed in November urged hospitals to start cooling some heart attack patients for 24 hours to try to prevent brain damage. Kempenich was among the first in Minnesota to get the treatment.

“He was in a condition that we would never have thought him capable of waking up from again,” said Dr. Keith Lurie, a cardiologist at St. Cloud Hospital and professor at the University of Minnesota. “That’s what’s so exciting about this. We are redrawing the border between life and death with this technology.”

The $25,000 chilling device has made its debut in the past two months at the Mayo Clinic in Rochester and at Abbott Northwestern Hospital in Minneapolis, among others.

"We've already seen great outcomes," said Barbara Unger, the director of cardiac emergencies at Abbott. Davis said the effect of the machine is similar to putting ice on an injured ankle. "When you injure a tissue, whether it's an ankle or a brain, there's two things that happen," he said. The injured cells release toxins, and the toxins attack other cells, in a domino effect of destruction."What cooling down does is make the cells go to sleep so they're not active. So they don't release the (toxins)."

Experts caution that the therapy isn't perfect - it won't help most heart attack victims -but it should reduce brain damage and improve survival rates.

Here's a thorough look at the subject of chilling.



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