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Delivering “Cool Aid” to Stroke Victims: New Technique Can Help Save Lives

Monday, March 12, 2001 at 5:41 AM

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Stroke is the third leading cause of death in the United States. The Cleveland Clinic is leading an international study to test a device delivering the chill that could save your life. 90.3's Renita Jablonski has more on this "cool" new therapy.

Karen Grant- They said pretty much that they didn’t think I would even live, let alone do as well as I’m doing.

Renita Jablonski- Karen Grant is a 44-year-old mother from Shalersville Township near Ravenna. She suffered a severe stroke last January. Grant says today she’s able to take care of her kids and lead a normal life thanks to hypothermic therapy.

KG- They thought I would at least be in a wheelchair which I’m not. I walk all by myself, I have no problems with that. My left arm is coming back really well, my speech is coming back.

RJ- Researchers say lowering body temperature shortly after a person experiences a severe stroke may protect against permanent brain damage and has the potential of increasing the mortality rate significantly. Dr. Michael DeGeorgia is one of Grant’s doctors and head of The Cleveland Clinic’s Neurological Intensive Care Program.

Michael DeGeorgia- Everybody can recall the anecdotal stories of a kid falling through the ice who is underneath the water for a few hours and then somehow they come out okay and everybody understands the concept that cold temperature can be protective.

RJ- Pretty cool, but using this concept in medicine is nothing new. Hypothermia has been used for decades in patients undergoing bypass and brain surgery.

MDG- It tended to be abandoned in the 70s and 80s, late 70s and that coincided with the development of other drugs, of other medications that were being tried and we learned more about ischemia and we thought that we were going to be very clever and create a medication that will block exactly the arrow that is causing this ischemia.

RJ- That’s the damage that occurs to brain tissue when a blood clot prevents blood flow and other necessary nutrients from reaching the brain. The drugs didn’t work as well as expected, so in the last few years there’s been a resurgence in the medical world to give cold another try. Until now, surface cooling, the procedure used on Grant, was the only method available to chill a patient - a very labor intensive and uncomfortable process.

MDG- Basically you pack the person in ice, but because you’re packing them in ice they shiver, it’s uncomfortable which means you have to give a sedative medicine and because they shiver, the shivering prevents you from reducing your core temperature cause shivering generates heat, you have to essentially paralyze the muscles, you paralyze the muscles then of course you can’t breathe on your own, you have to be put on a respirator.

RJ- But this machine may change all that. A little noisier than your refrigerator, it works to do the same thing—to preserve something by cooling it—but not last night’s leftovers; rather, your body. Dr. DeGeorgia is one of the visionaries of “Cool Aid,” an international study testing a cold-tipped catheter device that cools the body from the inside, eliminating many of the complications associated with surface cooling. Mike Dineen is with Radiant Medical based in Redwood City, California, the company responsible for developing the “SetPoint System.”

Mike Dineen- We’re able to cool quickly, we’re able to cool precisely, but we’re able to do it with a very small insertion size, very similar to what you would have in a balloon angioplasty procedure. It’s just through a small sheath that goes into the leg artery, into a vein in the leg and it’s advanced just below the heart.

RJ- The catheter expands in the body and cold saline is circulated through the catheter to cool the patient’s blood. The machine itself is simple looking—like a streamlined R2-D2—and it’s just as simple to operate.

MDG- Okay, so it’s at 33 and then set the cooling rate, we want to go as fast as we can so it’s set at maximum and then to begin cooling patient you press enter and then this will get cold again.

RJ- And with the combination of the internal cooling and a warming blanket on the patient’s chest, the body’s tricked into feeling just fine.

MDG- So it’s kind of like drinking Schnapps, or Brandy or Whiskey, that the reason that you feel warm is because your, the blood vessels in your skin dilate and you get flushed and you feel warm and toasty but in reality your core temperature goes down.

RJ- And the hope for surviving a stroke goes up. Or at least, that’s what the study is indicating so far. Grant is already a believer.

KG- People need this. And I’m not that old and what would I have if I was all disabled and couldn’t walk, couldn’t talk? I mean, I have my facilities about me and I could think and I wouldn’t have that if it wasn’t for that treatment. I couldn’t be more grateful.

RJ- The system will also be tested in at least five other medical centers in the US, as well as Germany and Australia. If all goes well, “Cool Aid” may become a regular part of stroke treatment as early as 2002. And if Dr. DeGeorgia has it his way, soon everyone will be saying his new favorite catch phrase - “stay cool, get well.” Renita Jablonski, 90.3, 90.3 WCPN.

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