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Study suggests physicians wait longer for brain recovery after hypothermia Rx in cardiac arrest
Date:11/13/2010

even seven days after suffering cardiac arrest," says Eid, who is scheduled to present the team's findings Nov. 13 at the American Heart Association's (AHA) annual Scientific Sessions in Chicago.

"Physicians and family members may need to wait longer than the traditional three days before making irrevocable decisions about brain function recovery and possible withdrawal of care," says Eid, an assistant professor at Johns Hopkins. The Johns Hopkins study is believed to be the first timeline analysis of neurological recovery after hypothermia treatment in victims of cardiac arrest.

"An obvious concern in light of these results is that we may be withdrawing support prematurely in selected patients," says Chandra-Strobos. "The concern is valid; however, our clinical and study experience are re-assuring since most patients are observed and treated more than seven days." The average length of stay at Johns Hopkins Bayview for such patients is 13 days, which she says is more than adequate to allow for neurological recovery.

The chilling and coma therapy itself typically lasts less than 24 hours, and patients are slowly weaned off powerful sedatives and simultaneously warmed up to a normal body temperature of 37 degrees Celsius. Experts say that if an ambulance reaches an arrest victim shortly after they have collapsed, the patient can be chilled in the hospital emergency room or in the intensive care unit within a few hours to the desired temperature -- 33 degrees Celsius -- using a combination of cold intravenous solutions and "ice blankets," suits, vests or helmets.

Not all victims of cardiac arrest, they caution, are candidates for therapeutic hypothermia. According to Eid, the treatment works best when emergency personnel are by the side of the patient at the time of actual collapse and can start immediate CPR and restart the heart, usually with a combination of drugs and sometimes electrical shock from a defibrillator. The tr
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Contact: David March
dmarch1@jhmi.edu
410-955-1534
Johns Hopkins Medical Institutions
Source:Eurekalert

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