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Cold-Hearted Savior
Induced hypothermia is helping put heart attack-related deaths on ice.

By Joan Elovitz Kazan

The morning of Feb. 3, 2011, started typically enough for 67-year-old Jerome Schrantz. He drove to his daughter’s home to give his 6-year-old grandson, Tyler, a ride to preschool. But what happened next was anything but typical.

“I heard him come in the door, then it sounded like the chairs fell over in the kitchen,” says Schrantz’s son-in-law, Ben Hartley. “Tyler came yelling, ‘Papa passed out!’”

Hartley ran to the kitchen and found Schrantz unconscious. He dialed 911 and sent Tyler out to the sidewalk to flag down the ambulance. They live across the street from the Waukesha Fire Department, and paramedics arrived in less than five minutes.

That quick response is a primary reason why Schrantz is alive and well today. “The keys to survival of a heart attack are early CPR and early defibrillation,” says Dr. Matt Weinberg of Cardiology Associates of Waukesha, who treated Schrantz. Another reason is a relatively new treatment called induced hypothermia.

When Schrantz arrived at Waukesha Memorial Hospital, emergency room doctors ordered a CT scan to see what effect the cardiac arrest had on his brain. When the scan came back clean, doctors immediately initiated the hypothermic protocol, which is what hospitals call the method by which they carry out induced hypothermia. Doctors used a cold saline intravenous infusion, “to cool the body to a temperature of 89.6-93.2 degrees Fahrenheit over four hours,” Weinberg says. “Like a bear hibernating, we try to slow down brain activity to minimize energy needs.”

During the procedure, the patient is kept sedated. “They are totally suppressed and paralyzed for 24 hours and maintained there for another 24 hours,” Weinberg says. “They don’t get woken up until around day three when we turn off the cooling process, and they naturally rewarm, which usually takes around 12-24 hours.”

Dr. Michael Brin, medical director of the emergency department at Columbia St. Mary’s Hospital Ozaukee, explains: “Induced hypothermia is a way to try to protect the brain, to preserve neurological function.” When the body suffers a trauma, like a cardiac arrest, the production of free oxygen radicals begins. Those toxins float through the blood and go to the brain, where they can cause a loss of neurological function. “The cooling process significantly limits the production of the free oxygen radicals,” Brin says.

In addition to cardiac patients, spinal cord and stroke patients are good candidates for induced hypothermia. In 2007, the treatment received national media attention when Kevin Everett of the NFL’s Buffalo Bills suffered a spinal cord injury during a game and was treated with induced hypothermia. Brin believes that treatment prevented further spinal damage and is one of the reasons Everett is able to walk today.

Although many hospitals and first responders have embraced the procedure, some are slow to do so. “At Columbia St. Mary’s, we’ve had this protocol for at least the past four to five years,” Brin says. “Many places still are not using it or are just in their infancy of creating a functional protocol.”

It took a long time, but Schrantz made a full recovery. Although the memory of that day and the week that followed is vague, Schrantz has repeatedly heard how lucky he was that his son-in-law and grandson were there when he needed them.

“Eight days later, I woke up in the hospital,” he says. “I’m just thankful to be here.”

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