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Feb. 01, 2012

Cool Medicine

by Sam Flatow

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As a fan of exotic medical treatments, I thought it might be a good idea to cover something a little more tasteful than maggots this time. Instead, I present the underutilized field of therapeutic hypothermia.

As the name suggests, therapeutic hypothermia is the act of cooling the body down, most commonly to aid in the treatment of cardiac arrest. Cardiac arrest causes 300,000 hearts to stop in America every year. Less than 10% of the owners of those hearts will survive long enough to leave the hospital. Even if you are lucky enough stay alive without a heartbeat for a significant period of time, the lack of circulation may mean that some of your brain cells have suffocated.

A study published in the New England Journal of Medicine way back in 2002 found some good outcomes for therapeutic hypothermia. Keep in mind that the survival rate of this study is much better than the 10% mentioned earlier because resuscitation was attempted on everyone between 5-15 minutes after the heart attack, so it doesn’t take into account those who were alone or unable to get help in time. Of the people put on ice, 55% survived and suffered little or no brain damage after 6 months, compared to 39% of the control group.

You’d think that getting dumped in a freezer would lower your chances of a good recovery. Well, Anna Bågenholm is glad that a little cold is a good thing. For her, a LOT of cold was a good thing. Anna had the privilege of accidentally becoming a case study for therapeutic hypothermia when she fell face-first through a frozen stream in a skiing mishap . Trapped under the ice, she found an air bubble, which sustained her for 40 minutes before her heart gave out. Rescuers couldn’t get her out for another 40 minutes.

Anna reached the hospital an hour after being dragged from beneath the ice, Once there, doctors found her body temperature to be a crisp 56.7 degrees, the lowest recorded temperature at which anyone has survived. Nine hours and a rotating staff of 100 doctors and nurses later, she was alive. It turns out that the 40 minutes she spent breathing out of that air bubble gave her body time to cool, which slowed her metabolism to a fraction of its normal speed. By the time her heart had stopped working, her brain didn’t need much of the oxygen that her blood couldn’t deliver. As a result, she didn’t have any brain damage. After 2 months, she left the hospital with only minor nerve damage in her hands.

Despite the miraculous recovery of Anna Bågenholm and several papers highlighting the merits of therapeutic hypothermia, a recent study published in Therapeutic Hypothermia and Temperature Management found that few doctors use this technique. Of the 26,519 patients of cardiac arrest studied in the paper, only 92 patients were treated with hypothermia. That’s 0.35%. Why aren’t we using such a useful tool to fight against such a common and deadly disease? Well, the treatment isn’t widely available partially because doctors don’t have the knowledge or equipment to use it. Hopefully, the future will be a little colder for medicine.

About Sam Flatow

Sam is an assistant producer at Science Friday where he prepares the tasty SciFri snacks and blogs about smart cephalopods and zombie ants.

The views expressed are those of the author and are not necessarily those of Science Friday.

Science Friday® is produced by the Science Friday Initiative, a 501(c)(3) nonprofit organization.

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