As an air conditioning contractor, Joseph "Mike" Kalil made his living off of a technology that keeps people cool. Now he owes his life to it.
Although he suffered a heart attack six years ago, he had no reason to think he was anything but healthy -- no shortness of breath, no chest pains. But on Aug. 17, Kalil's heart shut down and he collapsed on his bedroom floor. His wife, Reba, began administering chest compressions until paramedics arrived and took him to University Medical Center.
There, doctors stabilized him before using ice packs and cooling blankets to lower his body temperature -- inducing mild hypothermia to reduce brain damage and improve recovery.
Kalil, who is 50 years old, was unconscious for eight days following the arrest. But unlike when he had his heart attack, and his memory of the time around the event was "permanently erased," he started to remember things as soon as he awoke.
In sudden cardiac arrest, the heart stops beating and no blood is pumped to the brain and other organs. Death usually occurs within minutes unless the patient receives chest compressions and rapid defibrillation. Despite surviving the arrest, some patients remain in a coma and never recover from brain injury.
Inducing mild hypothermia, 32o-34o Celsius (89.6 o- 93.2o Fahrenheit), has been shown to improve neurological outcome following cardiac arrest and potentially could improve a patient's recovery and quality of life.
Physicians at UMC are looking at ways to make the process even more effective. UMC is one of several hospitals nationwide involved in the RESCUE trial, which will measure the Medivance Arctic Sun® 2000 Temperature Management System against traditional means of cooling patients, such as water blankets and ice. The system circulates chilled water into pads that are wrapped around 40 percent of the patient's body, offering rapid and controlled cooling.
The study will be conducted over an 18-month period at six to 10 hospitals. Patients will be cooled to 33.5°C (92.3°F) for 24 hours and then gradually rewarmed over six to 12 hours.
Research indicates that hypothermia could be helpful in other traumatic events, including stroke and other types of brain injuries. Unlike the hypothermia that occurs when a person falls into extremely cold water, therapeutic hypothermia is a highly controlled process and temperatures do not drop low enough to cause problems typically associated with accidental hypothermia.
"Inducing mild hypothermia in certain patients has been shown to have effective outcomes and we hope to add to the body of knowledge and the refinement of the application of this potentially lifesaving treatment," said Arthur B. Sanders, MD, a professor of emergency medicine and a member of the Cardiopulmonary Resuscitation Research Group at The University of Arizona Sarver Heart Center. Albert B. Fiorello, MD, and Kathy Hiller, MD, both assistant professors in emergency medicine, also are co-investigators in the study.
More information is available at:
The UA Sarver Heart Center CPR Research Group, www.heart.arizona.edu.
Medivance Arctic Sun® 2000 Temperature Management System, www.medivance.com