N.Y.C. implements hypothermia protocol

Issue: January 2009

A new initiative being implemented in New York City will alter the emergency protocol for certain patients being taken to the hospital for cardiac arrest.

The initiative, which is scheduled to take effect on Jan. 1, 2009, requires that eligible patients being transported to the hospital for cardiac arrest instead be routed to hospitals that have the ability to use therapeutic hypothermia, according to David J. Prezant, MD, medical director for the Fire Department of New York and professor of pulmonary medicine at the Albert Einstein College of Medicine in the Bronx.

According to Eyal Herzog, MD, director of the cardiac care unit at St. Luke’s-Roosevelt Hospital in New York City, the initiative could help some patients avert neurological damage. After several years of development, Herzog’s institution implemented a protocol similar to the initiative that required the use of therapeutic hypothermia in eligible patients in cardiac arrest. The first patient admitted under that protocol was admitted in March 2008.

“In our institution’s experience, we had 15 patients present with cardiac arrest under our own protocol,” Herzog told Cardiology Today. “Out of those 15 patients, seven actually left the hospital with normal neurological recovery.

Herzog thinks that the initiative can be easily integrated into other hospitals and noted that many hospitals.

“All of the major medical centers in Manhattan, to my knowledge, have this technology,” Herzog said. “It is not an expensive technology. I hope that other institutions will mimic the same excellent results that we had.” – by Eric Raible

The story for hypothermia for preservation of brain function after cardiac arrest is reasonably compelling. As more sites do this, I think it is important to examine the data and see if the results in real world practice are in fact as good as the early published reports.

Deepak Bhatt, MD
Cardiology Today Editorial Board member