N-ice Save Doc!

Doctors nearly freeze a woman's brain to save it

Saturday, Nov 15, 2008  |  Updated 12:47 PM CDT
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N-ice Save Doc!

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Doctors kept Billy Broadhead's body temperature at 90 degrees -- 5 degrees below the hypothermia threshold -- for an entire day.

Wilma Broadhead, 76, had undergone a successful routine fix of a gastrointestinal bleed and had been cleared to leave Utah’s Timpanogos Regional Hospital.

But the Orem woman’s daughter, MykeAnne Hurst, still had an unsettling feeling.

"I don't know what it was,” she said. “ I just looked at my dad and said, 'No, I think she needs to stay another night.'"

Perhaps the feeling was providence. Later that night, Broadhead — who prefers to be called Billy — went into full cardiac arrest. The condition is fatal to about 95 percent of victims, said Dr. Martin Lee, director of the hospital's intensive care unit.

Broadhead's life was saved, but her troubles weren't over. The cardiac arrest caused a shortage of blood to her brain, which could cause neurological damage and eventually kill her.

So the Timpanogos team proposed a relatively new procedure, one that has only been used at the hospital about 10 times in the past three years: therapeutic hypothermia.

The technology has been around for about a decade and is gaining acceptance in the medical world, Lee said. Doctors had noticed that people could fall through sheets of ice into freezing water for as long as 15 or 20 minutes and then recover with no major neurological damage.

"When you cool your brain cells, in part what happens is their metabolism slows to the point where they don't need much oxygen to survive," he said. "They've found that the cold has protected their brains from significant damage."

So Broadhead was brought to the ICU, where a cooling device called the Cincinnati Sub-Zero was placed on her body. Over the next six hours, her body temperature was carefully lowered to about 90 degrees -- 5 degrees below the hypothermia threshold. It remained there for the next 24 hours.

Lee said there are always health concerns associated with hypothermia — falling heart rate, failure of blood to clot — but under careful monitoring they can be controlled. He would recommend the procedure for virtually anyone, he said.

Studies are still emerging to suggest how many patients retain better neurological function with therapeutic hypothermia.

After the 24 hours had elapsed, it was time to wake Broadhead up and evaluate her thinking ability. Hurst, her daughter, said she was frightened.

"She was so cold," she said. "It was just constantly we wanted to cover her up. She just looked almost like she was frozen."

But initial tests were great, Lee said.

"She retained full neurologic function despite the cardiac arrest," he said. "She had no significant damage that I could find."

Broadhead is now recovering with her husband in her Orem home. She remembers entering the hospital and coming out, but nothing in-between. She has a hard time remembering some things, Hurst said, but that's improving every day.

Recently, Broadhead was able to fulfill a lifelong dream of spending a week at a condo on the Oregon coast.

Lee wouldn't say whether he thought the hypothermia saved her mind. But Hurst was enthusiastic in her praise.

"I'm fairly certain that if they didn't do what they did at the hospital, she wouldn't have been the person she was before," she said. "We are very thankful that we have more time with our mom."

 

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