Intentional Hypothermia

Sixty one year old Bill Bondar considers himself a very lucky man. His wife believes that he was raised from the dead. Sometime in May 2007, Bill and his wife Monica had attended a jam session and were returning home. Just as they neared their house, Bill collapsed. Medical help was sought and, upon arrival, the paramedics helped to revive Bill’s heartbeat. But was the damage done already? Luckily for Bill, he was taken to the Hospital at the University of Pennsylvania (HUP) were Dr. Lance Becker and his colleagues were engaged in testing a new treatment method, believed to have the potential to restore thousands of lives.

The Procedure

At the HUP, chilled saline was injected into Bill’s body, after which his entire body was wrapped with cooling pads. His body temperature plummeted to 92 degrees from the normal 98. He was kept in this ‘state of existence’ for twenty-four hours. Bill Bondar survived his ordeal, and the revolutionary procedure, predicted to create many a medical ripple, is called ‘Intentional Hypothermia’. It is the intentional reduction of the body core temperature to 95°F or below, for medical purposes.

Back to Basics

Human beings are ‘homeothermic’; in other words they have a core body temperature (98 F), which does not fluctuate in accordance with the ambience. Hence, humans are also referred to as ‘warm-blooded’beings. However, this dogma is susceptible to change during extreme conditions.

During a cardiac arrest, the rhythmic ‘lub-dub’ of the heart caeses. The ‘oxygen-deprived’ cells of the vital organs, such as the brain, get permanently damaged. If this is not rectified immediately, death results within a short span.

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Although cardiopulmonary resuscitation is capable of reviving circulation in the brain, there is escalated neuronal damage when oxygen and other nutrients are re-introduced into the abnormal cells. As the cells die, they encourage their neighboring cells to begin apoptosis or programmed cell death.

Intentional hypothermia, on the other hand, minimizes cellular damage, and makes it easier to revive individuals who have suffered a cardiac arrest. It is also believed that intentional hypothermia helps to minimize cell death by lowering the metabolic activity of the brain.

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Past and present relevance

Intentional hypothermia is hardly a new- age phenomenon. The ancient Egyptians used it to treat severely febrile conditions, while the Europeans of the Middle Ages, including Hippocrates, put its analgesic properties to good use. Napoleon’s medical man is known to have employed ‘Cryoanalgesia’ while performing amputations. He discovered that packing a limb with ice, helped to prevent bleeding, besides controlling pain.

Today, intentional hypothermia is primarily employed during heart surgery. It is also used during other procedures, such as transplant surgeries, and is being used to treat devastating conditions such as spinal cord injury. For over 50 years, this procedure has been used to preserve organs for transplant surgeries, from 6 to 48 hours.

Dr. Becker, however, acknowledges the need for faster cooling methods. He intents to develop a slushy variety of saline with ice particles, which could quicken the dip in body temperature. Although the experimental procedure carried out on Bill Bondar is restricted to a certain category of patients, Dr.Becker believes that it will eventually become a part of critical care, helping to restore several lives.

Bill Bondar is now on medications and carries an internal defibrillator. Snatched from the ‘jaws of death’ and armed with a new perspective, his wife and he have returned to re-invent the joys of their boating life!

Source-Medindia