How therapeutic cooling saves lives
Just minutes later, Alicia's heart stopped beating. The active 34-year-old—whose only vice is an occasional chocolate chip cookie—had experienced sudden cardiac arrest. Unlike a heart attack from a blocked artery, cardiac arrest in someone this age can be caused by a problem with electrical impulses in the heart. Most people die within minutes, and those who survive often face long-term brain damage.
"Alicia was very lucky," says Linda DeStefano, R.N., a board-certified acute care nurse practitioner and critical care nurse specialist at Saddleback Memorial. "Her husband started CPR right away and the paramedics, who arrived in record time, were able to restore her heartbeat with a defibrillator."
Just as important, Alicia was transported to Saddleback Memorial, a designated cardiac and stroke-neurology receiving center that delivers the highest level of emergency and critical care to cardiac patients. This includes a revolutionary protocol called therapeutic hypothermia, which helps improve outcomes for people who experience cardiac arrest. "During therapeutic hypothermia, the patient's body is cooled to 89.6 to 93.2 degrees Fahrenheit for 24 hours," Linda explains. "This helps slow the production of toxins that damage the brain."
BACK TO LIFE
Alicia arrived at Saddleback Memorial around midnight. In the ER, her situation was considered very critical. "She was on full life support and in a medically induced coma to prepare for the cooling procedure," her husband says. "No one expected her to make it." But even as Alicia was receiving the last rites, the Saddleback Memorial staff was preparing to cool her with ice packs and an infusion of cold liquids. "It's essential to lower the temperature as quickly as possible because time is brain," Linda explains. John says that Linda left his wife's side just once during the next 24 hours—to find a cell phone charger for him so he could stay in touch with family members.
Rewarming Alicia's body to a normal temperature had to be done slowly and carefully. This process is the most critical and potentially dangerous part of the treatment and takes about 12 hours or longer to return to normal body temperature. "It's a challenging process to return a patient to normal body temperature and requires constant monitoring and close observation," Linda says.
Alicia experienced a setback when she needed dialysis for temporary kidney failure. Still, things went so smoothly that she was removed from the respirator and dialysis machine two days after she was admitted. From then on, John says, she got progressively better. "She opened her eyes, started speaking coherently and her smile was back—her beautiful smile. She was fantastic, unbelievable," he recalls. "The entire health care team, friends and family—everyone was ecstatic."
Less than a week after she was admitted, Alicia was released from the hospital with a special pacemaker called a cardioverter-defibrillator. The implanted device helps control the irregular heartbeats that can lead to cardiac arrest. Alicia couldn't be happier. "Thanks to the unbelievably caring and dedicated people at Saddleback Memorial, I'm walking with the twins every day, enjoying family activities and living a perfectly normal life."