Giving Patients an Icy Reception
Courtsey: Orlando Medical News, LYNNE JETER
ThermoSuit body-cooling system shown inflated above. |
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Thermosuit® Improves Recovery Odds for Osceola Regional Heart Attack Patients
Kissimmee— Because it could improve their chances of a full recovery, the emergency room staff at Osceola Regional Medical Center doesn’t mind giving heart attack patients an icy reception.
When it was introduced in August, Osceola Regional Medical Center became the first hospital in Florida to use the ThermoSuit® Body Cooling System, the only device using cold water immersion to rapidly lower patient temperature. The rapid cooling system has been proven to improve recovery by minimizing brain and tissue damage for cardiac arrest patients.
“There’s substantial research demonstrating that when a patient survives cardiac arrest, neurological recovery can be significantly improved by decreasing the body temperature and maintaining a reduced temperature for 24 hours,” explained Brian Baxter, MD, medical director of the Emergency Department for Osceola Regional. “The ThermoSuit allows us to advance the standard of care for cardiac arrest patients who have spontaneous return of circulation and to reduce their neurological impairment.”
ThermoSuit is used only with patients who have been successfully resuscitated after their heart has stopped.
Here’s how it works: when a heart attack patient arrives at Osceola Regional, the hospital initiates an ICE Alert. If appropriate, the patient is placed in the ThermoSuit, a non-invasive, portable cooling system that resembles a plastic raft. The FDA-approved device drops the body’s core temperature to between 32 and 34 degrees Celsius in roughly 20 minutes. When cooled, vital organs operate more slowly and require less oxygen, reducing the potential for permanent damage.
Once inside the suit, the patient is covered with a sheet; the system continuously pumps a thin film of ice around the patient’s body. Then, “a probe is placed in the patient’s esophagus to measure their core temperature,” said Baxter. “The device stops cooling at a certain temperature to prevent the patient from becoming too hypothermic. We then monitor the patient’s temperature for the next 24 hours as well as all of their other vitals.”
Once cooling is completed, the ThermoSuit is removed and the patient may receive additional treatments, such as angioplasty or stents.
Osceola Regional staff members completed specialized training before the hospital launched the ThermoSuit program. The medical center also collaborated with emergency medical service agencies in Kissimmee, St. Cloud and Osceola County to ensure a smooth transition between emergency transport and Osceola Regional.
“Once a cardiac patient has been resuscitated, we can immediately begin the cooling process,” said Baxter.
Of the other hospitals using other cooling methods for heart attack patients, most employ systems that have drawbacks. For example, external cooling techniques—namely ice packs and cooling blankets—take hours to decrease body temperature. In the meantime, brain cells and neurons are lost, dramatically diminishing a patient’s chances of returning to normal. Also, invasive cooling methods, such as endovascular cooling catheters and cold saline, tend to have complications.
Research has suggested that cooling the temperature of some cardiac arrest patients before coronary reperfusion could result in a significant reduction in the amount of injury the heart sustains.
Since rolling out the ThermoSuit program, feedback from heart attack patients and their families has been overwhelming positive, said Baxter. “Two of the three ThermoSuit patients have had full recovery after cardiac arrest and another is improving,” he said.
“The ThermoSuit System is the most advanced technology to treat cardiac arrest patients today,” said Paul McMullan, MD, interventional cardiologist at Ochsner Medical Center in New Orleans, La., which adopted its use last year. “It cools a patient in minutes, not hours like similar technologies currently available, when time is of the essence.”
McMullan pointed to a 50-year-old Ochsner cardiology patient who was pronounced dead after suffering a heart attack in 2008. He was immediately resuscitated at the scene, suffered another heart attack, and was routed to Ochsner’s ER. After “cooling off” with the ThermoSuit,he recovered and was doing well soon after. His ejection fraction (EF), which was at 5 percent after his cardiac episodes, had returned to 35 percent.
Robert Freedman, MD, of Alexandria, La., invented ThermoSuit, which received a 2009 Medical Design Excellence Award.
“ThermoSuit will become the new standard of care for cardiac arrest patients,” said Baxter. “It fits with Osceola Regional and the Central Florida Cardiac & Vascular Institute.”
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Tagged: therapeutic, hypothermia, hyperthermic, cardiac arrest, heart attack, patient, cooling, hyperthermia, non-invasive, noninvasive, hospital, emergency, room, cardiology, thermosuit, lrs, life recovery systems, lora shipman, lora killeen, lora van zandt, cardiologist, fda, nursing staff, body-cooling, brain damage, cardiac care, Ochsner, florida, american heart association, lynne jeter, health journalist, health reporter, osceola regional, orlando medical news, interventional cardiologist, paul mcmullan md, dr. paul mcmullan, fda approved
An article published Online First and in the January edition of The Lancet Neurology reports that MRI scans on infants who’s brains were oxygen deprived can predict with 80 percent accuracy the likelihood of death or disability by eighteen months. Children whose brains are starved of oxygen at birth suffer less brain injury if they undergo therapeutic cooling. The article is the work of Dr Denis Azzopardi, MRC Clinical Sciences Centre, Imperial College London, UK, and colleagues.
Hypoxic-ischaemic encephalopathy is a condition that can be developed by babies who are starved of oxygen at birth. This is an important cause of mortality and morbidity in newborns. It accounts for about 20 percent of occurrences of cerebral palsy in childhood. The Total Body Hypothermia for Neonatal Encephalopathy (TOBY) trial has already been published. In this trial, infants who were allocated to prolonged moderate hypothermia showed no significant difference in the combined rate of death or disability at eighteen months. However, they had a reduced rate of cerebral palsy and improved mental and psychomotor outcomes compared with those allocated to standard care.
In this new study, the hypothesis is that whole-body cooling would be associated with a reduction in cerebral lesions seen on MRI that are characteristic of hypoxic-ischaemic encephalopathy, including those predicting neurodevelopmental impairments. The authors also proposed that cooling would not alter the accuracy of neonatal MRI for predicting neurological outcome at eighteen months of age. To investigate this hypothesis, they analysed the MRI scans for 131 of the 325 infants enrolled in the TOBY trial.
Results indicated that therapeutic hypothermia was linked to a 30 to 40 percent reduction in lesions in various areas of the brain associated with neurological development. Compared with non-cooled infants, cooled infants had fewer scans that were predictive of later neuromotor abnormalities. Also they were almost three times more likely to have normal scans. The accuracy of prediction by MRI of death or disability to eighteen months of age was similar in both groups. It was 84 percent in the cooled group versus 81 percent in the non-cooled group.
The authors explain: “The accuracy of MRI done during the neonatal period for the prediction of neurological outcomes up to 18 months of age was unaltered by therapeutic hypothermia. In this large cohort of infants who had an MRI after hypoxic-ischaemic encephalopathy, we found no unusual patterns of lesions and no increase in haemorrhagic or thrombotic lesions associated with therapeutic hypothermia.”
They write in conclusion: “Our finding that MRI at a median of 8 days accurately predicted outcome at 18 months of age in cooled and non-cooled infants is likely to be generally applicable. These data show that MRI in the neonatal period is qualified as a biomarker of disease and treatment response and might be of use in other neuroprotective studies.” In an associated comment, Dr Jeff Neil, Washington University School of Medicine, St. Louis, MO, USA, remarks: “[This study] provides valuable information for clinicians and establishes conventional MRI as a useful biomarker and potential surrogate endpoint for future cooling studies.”
He adds: “These findings emphasise the important role of MRI in neuroprotection studies. Appreciation of differential regional neuroprotective effects is crucial for advancing understanding of underlying mechanisms.”
“Assessment of brain tissue injury after moderate hypothermia in neonates with hypoxic-ischaemic encephalopathy: a nested substudy of a randomised controlled trial”
Mary Rutherford, Luca A Ramenghi, A David Edwards, Peter Brocklehurst, Henry Halliday, Malcolm Levene, Brenda Strohm, Marianne Thoresen, Andrew Whitelaw, Denis Azzopardi
DOI:10.1016/S1474-4422(09)70295-9
The Lancet Neurology
Written by Stephanie Brunner (B.A.)
Categories: Uncategorized
Tagged: body-cooling, brain damage, cardiac arrest, cardiologist, cardiology, CentraState, cooling, cooling therapy, emergency, fda, heart attack, hospital, hyperthermia, hyperthermic, hypothermic, hypthermic, life recovery systems, lora killeen, lora shipman, lora van zandt, lrs, non-invasive, noninvasive, nursing staff, patient, Patient Cooling, room, therapeutic, thermosuit, total body cooling
OSCEOLA REGIONAL MEDICAL CENTER FIRST HOSPITAL IN FLORIDA TO USE THERMOSUIT® FOR HEART ATTACK PATIENTS KISSIMMEE, FL, — As Emergency Department Medical Director for Osceola Regional Medical Center, Brian Baxter, MD, FACEP, doesn’t mind giving heart attack patients an icy reception—if it means improving their chances of a full recovery.
Dr. Baxter is enthusiastic about the Center’s new ThermoSuit® System, introduced in August of this year. “The ThermoSuit allows us to advance the standard of care for cardiac arrest patients who have spontaneous return of circulation and to reduce their neurological impairment,” he said. The technology is used only with patients who have been successfully resuscitated after their heart has stopped.
When a cardiac arrest patient arrives at Osceola Regional, the hospital initiates an ICE Alert. If deemed appropriate, the patient is placed in the ThermoSuit, a non-invasive, portable cooling system that resembles a plastic raft. The FDA-approved device drops the body’s core temperature to between 32 and 34 degrees Celsius within 10 to 30 minutes. Once inside the suit, the patient is covered with a sheet and the system continuously pumps a thin film of ice around the patient’s body. While this is happening, “A probe is placed in the patient’s esophagus to measure their core temperature. The device stops cooling at a certain temperature to prevent the patient from becoming too hypothermic. We then monitor the patient’s temperature for the next 24 hours as well as all of their other vitals,” explained Dr. Baxter.
This rapid cooling improves recovery by minimizing brain and tissue damage. “There is substantial research demonstrating that when a patient survives cardiac arrest, neurological recovery can be significantly improved by decreasing the body temperature and maintaining a reduced temperature for 24 hours,” Dr. Baxter said. Once cooling is completed, the ThermoSuit is removed and the patient may receive additional treatments such as stents or angioplasty. Before launching the ThermoSuit program, Osceola Regional staff members underwent specialized training. The hospital also collaborated with emergency medical service agencies in Kissimmee, St. Cloud and Osceola County to ensure a smooth transition between emergency transport and the Medical Center.
“Once a cardiac patient has been resuscitated, we can immediately begin the cooling process,” Dr. Baxter commented. Many hospitals use other cooling methods, but these have drawbacks. For example, external cooling techniques such as ice packs and cooling blankets, take hours to decrease body temperature. In the meantime, brain cells and neurons are lost, dramatically diminishing a patient’s chances of returning to normal. And invasive cooling methods, such as endovascular cooling catheters and cold saline, tend to have complications.
In the short time since Osceola Regional launched the program, the results have been positive. According to Dr. Baxter, “Two of the three ThermoSuit patients have had full recovery after cardiac arrest and another is improving.” Currently, Osceola Regional is the only hospital in Florida using this technology. “ThermoSuit is the new standard of care for cardiac arrest patients. It fits with Osceola Regional and the Central Florida Cardiac & Vascular Institute,” Dr. Baxter noted.
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About Osceola Regional Medical Center: Osceola Regional Medical Center is a state-of-the-art hospital offering services which include: a 24-hour Emergency Department; 24-hour Obstetrician (OB) Coverage/Baby Suites Maternity Unit; Level II Neonatal Intensive Care Unit; Pediatrics; Accredited Chest Pain Center; Certified Primary Stroke Center; Orthopedic and Spine Center; Wound Healing Center; and the Kissimmee Physical Therapy Center. Also included are complete diagnostic, imaging and testing services in the Osceola Imaging Center and the Breast Care Center. The hospital features a premier multi-million dollar, four-story cardiac care tower housing the Central Florida Cardiac & Vascular Institute. The Institute offers advanced comprehensive cardiac care from diagnostics and treatment, including open-heart and vascular surgery to cardiac rehabilitation. Many of the Institute’s surgeons specialize in minimally invasive heart valve surgeries. Visit www.HeartHappensHere.com for more information.
Categories: Uncategorized
Tagged: body-cooling, brain damage, Brian Baxter, Brian Baxter Cardiologist, brian baxter MD, cardiac arrest, cardiologist, cardiology, cooling, Dr., emergency, FACEP, fda, florida, heart attack, hospital, hyperthermia, hyperthermic, hypothermia, hypothermic, hypthermic, icy, kissimmee, life recovery systems, lora killeen, lora shipman, lora van zandt, lrs, MD, non-invasive, noninvasive, nursing staff, osceola regional medical center, patient, Patient Cooling, rapid, room, therapeutic, thermosuit
Categories: Therapeutic Hypothermia
Tagged: ambulance, body-cooling, brain damage, cardiac arrest, cardiac care, cardiologist, cardiology, ccu, cooling, critical care, emergency, er, fda, heart attack, hospital, hyperthermia, hyperthermic, hypothermia, hypothermic, hypthermic, icu, life recovery systems, lora killeen, lora shipman, lora van zandt, lrs, non-invasive, noninvasive, nursing staff, paramedic, paramedics, patient, room, therapeutic, thermosuit
Therapeutic hypothermia after cardiac arrest: Unintentional overcooling is common using ice packs and conventional cooling blankets
Courtesy of: Acute Care Inc. Posted on September 5, 2009 by coptermedic From PubMed:
OBJECTIVES: Although therapeutic hypothermia for cardiac arrest survivors has been shown to improve neurologically intact survival, optimal methods to ensure controlled induction and maintenance of cooling are not clearly established.
Precise temperature control is important to evaluate because unintentional overcooling below the consensus target range of 32-34 degrees C may place the patient at risk for serious complications. We sought to measure the prevalence of overcooling (<32 degrees C) in postarrest survivors receiving primarily noninvasive cooling.
DESIGN: Retrospective chart review of postarrest patients.
SETTING: Three large teaching hospitals.
PATIENTS: Cardiac arrest survivors receiving therapeutic hypothermia.
INTERVENTIONS: Charts were reviewed if primarily surface cooling was used with a target temperature goal between 32 degrees C and 34 degrees C.
MEASUREMENTS AND MAIN RESULTS: Of the 32 cases reviewed, overcooling lasting for >1 hr was identified as follows: 20 of 32 patients (63%) reached temperatures of <32 degrees C, 9 of 32 (28%) reached temperatures of <31 degrees C, and 4 of 32 (13%) reached temperatures of <30 degrees C. Of those with overcooling of <32 degrees C, 6 of 20 (30%) survived to hospital discharge, whereas of those without overcooling, 7 of 12 (58%) survived to hospital discharge (p = not significant). CONCLUSIONS: The majority of the cases reviewed demonstrated unintentional overcooling below target temperature. Improved mechanisms for temperature control are required to prevent potentially deleterious complications of more profound hypothermia.
Categories: Patient Cooling · Therapeutic Hypothermia
Tagged: body-cooling, brain damage, cardiac arrest, cardiologist, cardiology, cooling, fda, heart attack, hospital, hyperthermia, hyperthermic, hypothermia, hypothermic, hypthermic, life recovery systems, lora killeen, lora shipman, lora van zandt, lrs, non-invasive, noninvasive, nursing staff, patient, room, russell van zandt, russell vanzandt, therapeutic, thermosuit
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Cooling Therapy: Cooling therapy could save heart attack victims by dropping their body temperature (Fox)
Watch Fox News Interview here! http://newsclipper.org/#63572
Categories: Patient Cooling · Therapeutic Hypothermia
Tagged: body temperature, cardiac arrest, cardiologist, cardiology, cooling, cooling therapy, fda, fox news, heart attack, hospital, hypothermia, hypthermic, life recovery systems, lora killeen, lora shipman, lora van zandt, lrs, non-invasive, noninvasive, nursing staff, patient, room, save heart attack victims, therapeutic, thermosuit
Technology helps recovery of cardiac arrest patients
CentraState’s Emergency Department (ED) in Freehold Township now offers a new rapid, body-cooling device for cardiac arrest patients to help them recover with minimal or no damage to the brain. Clinicians in the ED successfully used the device for the first time earlier this month on a 55-year-old male patient.
The emergency department is the first in New Jersey using the new ThermoSuit by Life Recovery Systems. Clinicians use the system to rapidly decrease a patient’s core temperature to around 92 degrees which slows blood flow to the heart and brain. “When the body is cooled down, the heart and brain require less oxygen to continue functioning,” says M. Michael Jones, MD, chair, Emergency Services, CentraState Medical Center. “This helps prevent further damage to the brain and creates better opportunity for healing with favorable outcomes.”
At CentraState, the ThermoSuit is used for patients after they’ve experienced cardiac arrest and have been revived, but are not responsive. Cardiac arrest is a condition in which the heart stops pumping blood as a result of irregular heart rhythms. According to the American Heart Association, 95 percent of people who suffer from cardiac arrest outside of a medical facility die before they reach the hospital.
The device is an inflatable pool that wraps around a patient’s body and then constantly pumps ice water across the body to remove surface heat, decreasing the body’s temperature quickly. Any time throughout the process, CPR and/or a defibrillator can be used if needed without disruption of the cooling. The “suit” is computer controlled and shuts down once the target temperature is reached. To maintain hypothermia, a simple iced saline infusion is used, and a patient can stay cold for around 24 hours.
The ThermoSuit can obtain the desired temperature between 93 and 90 degrees Fahrenheit in only 27 minutes. Past cooling methods took up to two hours and 43
minutes. The faster a hypothermic state is reached, the greater chance there is of preventing permanent damage to the heart and brain.
The non-invasive procedure has no reported complications and is the top in its category for reducing core body temperature.
Patient satisfaction at CentraState’s Emergency Department has ranked at the 96th percentile or higher for seven of the last eight quarters, according to a national patient satisfaction measurement firm. CentraState has one of the busiest emergency departments in Central new Jersey, caring for more than 60,000 patients per year.
— ANDY LAGOMARSINO, NEWJERSEYNEWSROOM.COM
Categories: Therapeutic Hypothermia
Tagged: body, body-cooling, brain damage, cardiac arrest, cardiologist, cardiology, CentraState, cooling, core temperature, cpr, defibrillator, device, emergency department, fda, Freehold Township, heart attack, hospital, hypothermia, hypthermic, life recovery systems, lora killeen, lora shipman, lora van zandt, lrs, New Jersey, non-invasive, noninvasive, nursing staff, patient, Patient Cooling, rapid, room, therapeutic, thermosuit
The ThermoSuit® Advantage
Easy to Use: The system is portable and easy to set up and initiate by the nursing staff. On-screen graphics display the current status of the system and the progress of the cooling process. When finished, the suit is discarded.
Fast: In a matter of minutes, the entire body is cooled to the optimal target temperature. Non-Invasive Surface cooling is achieved by circulating ice water directly over the patient’s skin.
Maximum Control: Level control valve automatically monitors fluid level and purges coolant when target temperature is achieved.
Mistake-Free: Automatic safety checks are an integral part of the design to eliminate errors, and the possibility of over-cooling. Temperature probe monitors and controls the patient’s temperature during the entire cooling process.
No Bed Sores: Patients are not tied to the system. The patented inner sling internal support surface inflates to surround and cradle the patient’s body.
Easy Access to Patient: Removable top sheet contains integrated flow channels and allows access to the patient during the cooling process.
No Hospital Should be Without The ThermoSuit® System!
Categories: Patient Cooling
Tagged: cardiac arrest, cardiologist, cardiology, cooling, emergency, fda, heart attack, hospital, hyperthermia, hyperthermic, hypothermia, hypthermic, life recovery systems, lora killeen, lora shipman, lora van zandt, lrs, non-invasive, noninvasive, nurse, nursing staff, patient, room, therapeutic, thermosuit
