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Coordinated Cooling Effort After Cardiac Arrest Can Improve Outcomes
Date:7/11/2011

The others were sent to this hospital immediately. Overall, 56 percent of patients who were cooled survived. Survival rates were the same among those who were transferred and those who received initial care at the treating hospital. Risk of death increased by 20 percent for every hour of delay in starting cooling.

Among survivors, 92 percent showed no sign of severe neurological disability, compared to 77 percent of similar patients treated prior to use of the new system. Patients had an average age of 62, and 77 percent were men. The older patients had greater risk for neurological damage, the study showed.

"People don't just arrest near large centers, but it's not hard to implement this program," said study co-author Barbara Unger, director of cardiovascular emergency program development for the Minneapolis Heart Institute.

"If a patient does not regain consciousness after cardiac arrest, you do an EKG to see if they also had a severe form of heart attack [ST-elevation myocardial infarction], and then you may pack them in ice," she said. "The patient is then transferred to a large tertiary center because you need a wide variety of specialists, including cardiologists, neurologists, emergency room doctors and critical-care nurses on board."

About half of all patients who received the cooling treatment were also being treated for ST-elevation myocardial infarction, she said.

Saving lives after cardiac arrest starts even before EMS arrives, Unger said. "Bystanders need to perform CPR and use a defibrillator to deliver an electric shock to the heart," she said. "We have great outcomes waiting for them, but they have to start it."

"Hypothermia is a very powerful treatment, but it has been a very slow process getting hospitals on board," explained Dr. Benjamin Abella, an assistant professor of emergency medicine and director of clinical research in the Perelman School of Medicine Center for Resuscitation Science at the University of
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