On average, a human’s body temperature runs at approximately 98 degrees Fahrenheit. After going into cardiac arrest March 20, Howard King, 74, of Ellendale had his lowered to 91 F at Bayhealth-Kent General Hospital. It may be part of the reason King is now finished with rehab, has been working in the garden and has been able to fit in a few slow dances at the Harrington Moose Lodge.
Research has shown that lowering a patient’s temperature after cardiac arrest can suppress cell damage in the brain. That damage harms cognitive abilities, sometimes rendering patients unable to care for themselves or effectively interact with others, according to Angel Dewey, clinical practice leader for intensive care at Kent General Hospital.
To squash those side effects, Bayhealth introduced Code ICY in March.
“I was really happy, right now, that they used it,” King said. “I don’t have any problems too much with thinking, and I’m getting around doing small work jobs outside, having no problems walking.”
The cooling process works with the help of a machine by Alsius, a company that develops intravascular temperature management. The machine was set to regulate King’s temperature from the inside via a catheter inserted into his central venous system, where three balloons were filled with saline. The machine kept the saline cold, so the balloons cooled the blood rushing over them, similar to water chilling after passing over ice.
The procedure is meant for patients who have had cardiac arrest, and who after CPR and/or some medication have been resuscitated within 30 minutes but are still comatose after the heartbeat returns. They also must be non-traumatic, so no serious car accidents, for example. Also, their core temperature has to be greater than approximately 93 F.
When King suffered the cardiac arrest, a friend used CPR to resuscitate him right away. That was a key to King’s qualifying for Code ICY, as was the prompt use of an automated external defibrillator by a member of the Felton Fire Company, according to Susan Ebaugh, clinical practice leader for the emergency department at Kent General Hospital.
“The immediate CPR was what probably saved his life,” Ebaugh said.
When they reviewed King’s case, Bayhealth staff knew he was the ideal candidate for Code ICY.
So he was sedated and given medication to paralyze the muscles so he wouldn’t shiver, which would cause the temperature to rise.
That was when the catheter was inserted and the cooling began.
The goal is to get the patient to 91 F within six hours of the arrest, according to Dewey. King was at the point well before the six-hour mark.
King was kept at 91 F for 24 hours, and then gradually re-warmed and kept at 96.9 F for 18 hours.
Then he was slowly woken up.
He was groggy, but the nurses could tell his brain was functioning properly.
Ebaugh realized it when he answered to his name.
“He immediately followed commands, and that was like, ahhh,” Dewey said.
King’s success was made sweeter to the nurses by the fact that they helped bring the technology to the hospital.
Joyce Hill, nurse manager for the intensive care unit at Kent General Hospital, was part of the team that introduced Bayhealth to the new technology.
The team researched the treatment and equipment, and took information about the internal cooling to Ann Keane, director for patient care services at Kent General Hospital. Keane embraced it, Hill said.
Bayhealth ended up buying three machines — two for Kent, one for Milford — to regulate temperatures during Code ICY. They knew going into it that only a small number of people would qualify for the procedure, and that the machines were pricey.
Hill, Ebaugh and Dewey are thrilled that the cost didn’t scare the hospital away.
“If we can return their quality of life to a very high level, it’s worth it,” Ebaugh said.
King’s quality of life is returning.
King said his balance is good, and he’s been keeping as active as possible.
“I’m not one to sit around,” he said. “I love to dance.”
King said he jokingly calls himself a popsicle, but all joking aside, said he feels stronger every week.
He had stents and an automatic internal cardiac defibrillator put in following the cardiac arrest, so he isn’t driving. But he is starting to get back to his routine, including taking care of his home and garden.
“I feel marvelous, in a way. Every day I live I feel grateful,” he said. “If it worked for me, maybe it will work for someone else.”
Milford, Del. —
