http://www.nytimes.com/2003/06/03/health/03TREA.html?ex=1056600000&en=23dfd61f02c32021&ei=5070

VITAL SIGNS

Treatments: Chill Therapy for Failing Hearts

By JOHN O'NEIL

Treating comatose heart attack victims by cooling them down, a relatively new practice, is effective because the cold not only slows the damage caused by the disruption of blood flow, but it also promotes the release of healing chemicals in the brain, a new study has found.

The study, presented at a weekend conference of the Society of Academic Emergency Medicine in Boston by Dr. Clifton W. Callaway of the University of Pittsburgh Medical Center, followed up on research in Austria and Australia on people whose hearts had been stopped by a faulty rhythm.

Although a third of the patients have their hearts restarted, just 10 percent survive without brain injury. The studies showed that lowering body temperatures moderately, to 91 or 92 degrees, had striking effects on injury-free survival, Dr. Callaway said.

The new study, conducted on dogs, found a strong benefit even when the cooling began an hour after cardiac arrest, he said.

The cooling appears to stimulate the release of chemicals known to promote healing in the brain, he said.

Dr. Callaway said he and colleagues had begun to apply the findings in emergency room care, using cold blankets and ice water pumped in and out of the stomachs of patients whose heart attacks were caused by rhythm problems.

Dr. Vinay M. Nadkarni, chairman of the American Heart Association's emergency cardiovascular care committee, called the technique "an emerging therapy" that would receive official support of the association in a few months.

"Clearly only a minority of emergency room physicians are doing that right now, but within the next year it will be used by the vast majority," said Dr. Nadkarni, who had no connection to the research presented in Boston.

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