Imagine, if you can, the experience of being near-dead, chilled literally to the bone – and then being brought back to life.
It may sound like the stuff of science fiction, but for 64-year-old Sherrie O., a medical technique called induced hypothermia is one of those unfathomables that has leapt from the pages of such Crichtonian imagination into astonishing reality.
And, it has everything to do with why she is alive today.
SH: Sherrie's Story
A little over a year ago, Sherrie, who lives in North Carolina, was visiting relatives in the Baltimore area when shoulder and chest pain prompted a phone call to 911. On the way to a local Maryland emergency room, she went into cardiac arrest. Emergency room staff defibrillated Sherrie 80 times, without much hope. But for an astute emergency room cardiologist who transferred her to St. Joseph Medical Center, Sherrie may not have seen the light of day again.
SH: Therapeutic Hypothermia
St. Joseph is one of few heart facilities in the nation to introduce induced hypothermia – also called mild therapeutic hypothermia – as a standard response to cardiac arrest in which ventricular arrhythmia occurs. In its simplest terms, the idea behind induced hypothermia is to cool the body down to a point at which damage to end organs – particularly the brain – can be circumvented.
“The procedure essentially slows down the injury of oxygen deprivation,” says St. Joseph pulmonologist Dr. Jason Marx, who performed the induced hypothermia procedure on Sherrie.
| “You’ve heard about kids who were at the bottom of frozen lakes, and they make it,” he explains. “That’s because the lowered body temperature basically decreases the brain’s metabolic demands, and allows it to regroup down the line.” |
Marx compares it to the “frozen lake” phenomenon.
“You’ve heard about kids who were at the bottom of frozen lakes, and they make it,” he explains. “That’s because the lowered body temperature basically decreases the brain’s metabolic demands, and allows it to regroup down the line.”
SH: A New Approach to Fighting Cardiac Arrest
Cardiac arrest kills more than 90 percent of its victims before they reach the hospital. Brain death can occur in four to six minutes. Those facts weighed heavily on Sherrie’s team at St. Joseph, which included interventional cardiologist Dr. Kerry Prewitt.
“The first thing we needed to do – and quickly – was to re-establish Sherrie’s heart rhythm,” he explains. “She was about as close to being dead as you can get.”
Sherrie herself has dim memories of the experience, but she does recall being told that during her transfer, emergency medical technicians couldn’t get a pulse.
“They couldn’t understand why the transfer was being done,” she remembers. “The thinking was that I was that far gone.”
SH: St. Joseph's Rapid Response
Once at St. Joseph, Sherrie’s team acted swiftly, first Prewitt performed an angioplasty to insert a stent into her left main artery, which would help to restore blood flow to her heart. With heart rhythm restored, Sherrie remained unconscious, which meant that her brain still was not getting adequate oxygen.
In that situation, the largest and most obvious concern is neurological damage. Thus, still unconscious, Sherrie began the purposeful descent into hypothermia to slow the potential for permanent damage.
Patients who are in a state of induced hypothermia remain “frozen” for between 12 and 24 hours. Besides the use of ice-cold fluid that is infused through a nasal gastric tube, patients are packed in ice under their arms, around their head and under their groin until their bodies cool to a temperature of between 32 and 34 degrees celsius.
“During that time, everything is slowing down,” says Marx. “Heart rate, metabolic activity and brain waves – basically, you’re decreasing oxygen consumption for the entire metabolic system and even potentially reversing any damage that may already have occurred.”
SH: Waking Up Without Brain Damage
After the crucial cool-down period, a patient is gradually warmed to normal body temperature. At that point, it becomes a waiting game to see whether a patient will wake up, according to Marx.
In Sherrie’s situation, her family had little hope and began saying their goodbyes. But, says Sherrie, “I must have had an angel in my room, and I know I had a lot of people doing their jobs to the fullest. They were the heroes here.”
Sherrie surprised everyone by not only waking up, but also waking up without any damage to her brain.
SH: Recovering a Normal Life
Today, back in North Carolina, she’s counting her blessings as she’s back in aerobics three times weekly.
“This experience – it will always be a part of my life,” she says. “It really puts things into perspective.”
St. Joseph Medical Center performs more heart procedures than any hospital in the state, and has been recognized more often than any Maryland hospital as one of the nation’s Top 100 heart centers.
Innovative procedures like mild therapeutic hypothermia are standards at St. Joseph, where your heart is in good hands.
