Body cooling may reduce brain damage risk after cardiac arrest
Cooling the body may reduce the risk of brain damage for cardiac arrest patients in a coma, a leading group of US neurologists says.
In cardiac arrest, the heart suddenly stops beating. This means blood and oxygen no longer flow to the brain. The longer the heart goes without beating, the greater the risk of brain damage or death.
Research suggests that body cooling reduces the risk of brain damage in cardiac arrest patients. The body is cooled on the surface with cold packs or special blankets, or internally with devices that cool the blood inside the vessels, according to a news release from the academy.
After HIV/Aids, heart disease and stroke are the second biggest killers in South Africa. Non-communicable diseases, including heart disease, are estimated to account for 43% of the deaths of adults in this country. Every day 210 people die from heart disease in South Africa.
The new guideline from the American Academy of Neurology recommends that families of these patients ask if their loved one qualifies for body cooling.
"People who are in a coma after being resuscitated from cardiac arrest require complex neurologic and medical care, and neurologists can play a key role in improving outcomes by providing body cooling," said guideline committee chair Dr Romergryko Geocadin.
This guideline recommends that cooling be used more often for patients who qualify, said Geocadin, who is with Johns Hopkins University School of Medicine in Baltimore.
Determining optimal temperatures
The guideline authors found "strong evidence" that cooling the body to 32 to 34 degrees Celsius for 24 hours (called therapeutic hypothermia) improves the chance of recovering brain function. "Moderate evidence" supported an approach called targeted temperature management – keeping the body at 36 degrees C for 24 hours followed by re-warming to 37.5 degrees C over eight hours.
"While there has been debate about which cooling protocol is best, our guideline found that both therapies have shown the same result," Geocadin said in the news release. "Families may want to ask their doctor if their loved one qualifies for body cooling."
The guideline, based on a review of studies conducted over the last 50 years, was published online in the journal Neurology.
Future studies should attempt to determine optimal temperatures, rates of cooling and re-warming the body, and which cooling methods work best, according to the guideline.