Therapeutic Hypothermia Improving Outcomes

February 11, 2013

Larry Lynn

HOT SPRINGS, Ark. -- Margaret Lynn had never heard of Therapeutic Hypothermia. But once it was suggested for her husband, she didn’t hesitate to say yes to the procedure.

Her husband, Larry Lynn, had just been brought to Mercy Hospital Hot Springs in cardiac arrest.

“I told them to do whatever they had to do to save his life,” she said. “I can’t say enough good things about Mercy. I’m thankful that we were here. I don’t think he would have made it if we wouldn’t have been here.”

Mercy Hospital utilized Therapeutic Hypothermia, a new procedure in Hot Springs, which is used for patients who survive a cardiac arrest but are not yet conscious. It has proven to be helpful in improving neurologic outcomes for some patients by decreasing the brain’s demand for oxygen and harmful chemical changes which could result in brain damage.

 “The purpose is to slow the brain down so it doesn’t incur significant brain injury due to a period of lack of oxygen that occurred while the patient was having a cardiac arrest,” said Mercy Hot Springs critical care physician Dr. Idrees Mogri. “If we can slow the brain down enough that the cells don’t die off and then re-warm the patient about 24 hours later, it has been shown that there is a much better chance of a positive outcome.”

A person’s normal body temperature is between 97.2 degrees Fahrenheit (36.2 degrees Celsius) and 99.5 F (37.5 C). If the body temperature is lower, the bodily functions slow down. The goal of Therapeutic Hypothermia is to cool the body temperature between 89.6 F (32  C) and 93.2 F (34 C).

The Lynns’ evening started just like many others. He was sitting in his favorite chair, relaxing and eating dinner. Margaret thought he had fallen asleep but quickly realized he was in cardiac arrest and called 9-1-1. She performed CPR until paramedics arrived and transported him to the Emergency Department at Mercy Hot Springs.

“When we got here, we had a huge crew ready to take over. They got him stable and did what they had to in order to save his life,” she said.

At the suggestion of a Cardiologist, she authorized Therapeutic Hypothermia for her husband.

“If we identify a patient, who has had a cardiac arrest, then cool them down with six hours to a temperature of about 32 degrees [Celsius] and keep them there for about 18 hours,” Dr. Mogri said. “That has been shown that it reduces the metabolic rate of the brain to a level that it doesn’t incur injury from a lack of oxygen.”

The patient is cooled using a large catheter placed in the femoral vein. It has a closed loop and circulates cold saline. This is connected to a console that quickly cools the patient’s core and precisely maintains the desired temperature for the specified time period. The patient is constantly monitored while going through the procedure with the patient’s temperature checked frequently.

 “As long as he was on it, there was a nurse in his room,” Margaret said. “And Dr. Nizar Suleman was in there, constantly monitoring him and just did a great job.”

After Larry was re-warmed he was responsive. He opened his eyes and answered to commands by squeezing hands and moving his feet. Days later he “woke up” to a feeling like he had been asleep.

“I picked up the phone and called the office, talked to my folks and reminded them about what we talked about before I left. Everything was fine,” he said.

Larry is getting back to his old routine, including daily walking.

“He remembers everything that happened beforehand. He’s normal,” Margaret said. “Everything is fine with his brain. No disability, nothing. He just functions like he did before all this happened.”

And Larry is thankful for those who took care of him.

“I firmly believe the hospital did a great job, the physicians did a great job, and I claim all my nurses were angels,” Larry said.


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