In 2005, the American Heart Association officially supported the treatment of lowering a patient's body temperature to help reduce the risk of injury to tissue, or therapeutic hypothermia, in certain circumstances. Around the same time, pulmonologist Anthony M. Costrini, MD, became a physician champion for introducing therapeutic hypothermia at St. Joseph's Hospital, home of The Heart Hospital and the Institute for Neurosciences.
"When I was in the military, I became interested in temperature regulation and treating heat stroke," Costrini says.
"During my residency I had the opportunity to treat homeless patients who suffered from cold exposure and hypothermia. So I've been interested in the extremes of body temperature through the years."
If a patient suffers from a severe ischemic injury (restriction in blood vessels resulting in damaged tissues) such as cardiac arrest, therapeutic hypothermia is used to help the patient stabilize and to protect tissues that may have not received the right amount of oxygen.
"The patient is wrapped in cooling pads that create what is effectively an ice blanket," Costrini says. "They are kept well sedated and have their temperatures dropped to 92 degrees Fahrenheit for 24 hours."
The benefits of this process include decreased energy demand on the body, decreasing the release of neurotoxic chemicals, and fever prevention.
"Our responsibility is then to support the patient through a slow re-warming process," Costrini says. He cautions that although therapeutic hypothermia has helped to enhance survivability, the odds of survival for patients who have out-of-hospital cardiac arrest are not promising.
"This procedure allows families time to come to grips with a catastrophic illness," Costrini says. "Even if the patient doesn't survive, this often gives the family a substantial amount of time to make decisions in a calmer, more thoughtful way."
For those that do survive a catastrophic event, Dr. Costrini believes that this non-invasive treatment can make a considerable difference.
"We hope that patients will survive with less deficits to their brain or heart muscle," Costrini says. "We hope they will have a better chance at a full, rather than limited, recovery."