Cooling Patients, Saving Lives

Research Shows Induced Hypothermia Can Improve Survival Rate Of Heart Attack Patients By 14 Percent

(CBS)  When 57-year-old Dean Cowles suddenly suffered a heart attack, he was lucky that he worked at a company that made defibrillators, CBS News medical correspondent Dr. Jon LaPook reports.

"Once we started CPR, Steve hooked one of the paddles and I hooked the other," says co-worker Oscar Rojas. "He started rendering the compression and I started mouth to mouth."

It's a story that still gives Cowles chills.

"Every time I hear this story, I get goose bumps," Cowles says. "It shakes me every time I hear that story, but yes, I was dead."

His colleagues managed to restart his heart. But what helped save his brain — and left him remarkably undamaged — was a simple procedure in the ER: chilling his body. It's called induced hypothermia. The idea is that cooling a comatose patient after a heart attack prevents brain damage.

"Anytime you can take someone who comes into the hospital after having cardiac arrest, who may not ever wake up, and you can potentially change that to someone who can wake up and become back the person they were the day before, it's an amazing thing," says Dr. David Likosky, a neurologist.

Research has shown it can improve the survival rate by 14 percent.

"We know how to use it but we really don't know how it works," says cardiologist Mark Vossler. "We know that people's neurologic outcomes are likely to be better if they get it but we don't completely understand what's happening in the brain for sure when the body is cooled."

Says Likosky: "If you cool the brain down, it may be that it uses less energy and (is) less likely to damage itself over that first 24 hours."

Ice packs can do the job, but new devices make it easier to reduce and regulate temperature. Pads are placed on the chest and legs, and cold water circulates through the pathways.

"The cooling pads are applied, and we bring their body temperature down to 91 to 93 degrees. We keep them at that temperature for the first 24 hours, at which time we re-warm them," Likosky explains.

The American Heart Association recommended more than a year ago using induced hypothermia for cardiac arrest patients who are stable. But most hospitals don't. It requires training and a lot of coordination.

"It should be more widely used. In medicine, in general, we have many very expensive treatments that may make a marginal difference — treatments that are potentially painful, that cost a lot," Likosky says. "This is ice, and it's a treatment that's very simple, and it's a treatment that makes a big difference: the difference between waking up and not."

Chilling the body may work miracles, but only if the patient survives to reach the hospital. Thanks to CPR and defibrillators, that's happening more often — and Dean Cowles is living proof.