Last month, a University of Minnesota researcher published an article about a protocol aiming to increase survival rates in patients who suffer cardiac arrest outside of a hospital.
University researcher Demetri Yannopoulos started investigating a new procedure to save the lives of those who don’t respond to initial attempts to restart their hearts after cardiac arrest nearly two years ago. His process, adopted by several area hospitals, can increase survival rates by about 30 percent.
In the standard procedure, emergency personnel defibrillate a person experiencing cardiac arrest — shock them — and if the person is not revived, they perform CPR for around 30 to 40 minutes. If the victim can’t be revived even with extended CPR, they are pronounced dead at the scene, Yannopoulos said.
Many of these victims who can’t be revived have something called refractory ventricular fibrillation, which means their heart can’t keep a steady rhythm, he said.
Under the new protocol — adopted by North Memorial Health, St. Paul Regions Hospital and HealthEast — if a patient can’t be revived after three shocks, they are rushed to the University.
The cardiac arrest patient receives continuous CPR from an automated device in the back of the ambulance as the University emergency department, the cardiac catheterization lab and Yannopoulos are notified of their situation.
Once at the University, the patient is hooked up to a device that acts as an external heart, drawing blood out and revitalizing it with oxygen, then pumping it back into the body. This works as the heart normally does and gives medical professionals the time to find the problem and fix it, if possible, Yannopoulos said.
“You’ve essentially taken that time-critical aspect of defibrillating people out of the question.” said Marc Conterato, an emergency medical physician at North Memorial hospital.
Yannopoulos said patients treated with the new protocol survive 45 to 50 percent of the time. Using standard practice, about 8 to 15 percent of people with refractory ventricular fibrillation survive, he said.
Many who die from cardiac arrest die because of brain injuries, as their brains are deprived of oxygen for too long. Yannopolous’ protocol lets them survive with their brains intact, he said.
First responders are grateful for the new approach, said Ralph Frascone, an emergency medicine doctor for St. Paul Regions hospital.
“They are definitely enthusiastic about this sort of approach and enjoy being on the cutting edge,” he said.