Thursday, April 5, 2012
Glucose Cocktail Limits Cardiac Arrest Damage
In short it appears to be safe enough to provide this dose at the first responder stage. Two percent damage versus ten percent damage is also a pretty compelling reason. I suspect that first responders are also aware now that CPR as heart massage must be maintained until the patient is taken off their hands. A tough job without assisting hardware, but that is coming also.
I suspect this protocol also applies to stroke victims as well. It sounds as if this is good enough to halt the damage process itself so that thinners can do their job also.
The cardiac departments were facing horrible statistics for patients coming in by way of an ambulance. We know now that abandoning CPR is a gross mistake because the CPR shuffles blood back and forth preventing cell death. Providing this cocktail by intravenous appears to prevent excessive cell death around the heart.
My own experience may have woken up folks. I suffered a major heart attack in June of 2006. My heart stopped immediately. My friend called 911 and applied immediate CPR (he was well trained and strong) My heart was not restarted for twenty minutes. In the end I effectively recovered fully except for a somewhat reduced heart function still well above the bad news guidelines.
Since then we have had the example of a machine assisted CPR case in Britain in which the patient fully recovered after two and a half hours.
I suspect that had this cocktail been available in my case, the damage would have been much reduced and complete tissue recovery may have been possible.
The take home is that first responders now have tools available that allows them to deliver savable patients to emergency.
By the way the statistics are awful. Only ten percent make it from an attack outside a hospital. This may well help us cut it in half at least. We will never be able to help those who succumb alone, but if help is minutes away survival can become probable.
Early dose of glucose thwarts cardiac arrest-study
Tue Mar 27, 2012 9:00am EDT
* Mix of glucose, insulin, potassium cuts risk in half
* Paramedics give treatment to heart attack patients
By Susan Kelly
CHICAGO, March 27 (Reuters) - Patients showing heart attack symptoms who received a mixture of glucose, insulin and potassium from paramedics were half as likely to go into cardiac arrest or die than those who did not receive the dose, a study found.
Researchers trained paramedics to administer the treatment after determining with an electrocardiograph-based instrument that a patient was likely having a heart attack. The results of the study were presented at a meeting of the American College of Cardiology in Chicago.
Although the treatment did not stop the heart attack from occurring, patients who received it were 50 percent less likely to go into full cardiac arrest, in which the heart suddenly stops beating, or to die, than those who received a placebo.
The study of 911 patients showed the treatment also reduced the severity of damage to heart tissue from the heart attack. In patients who received the mixture, 2 percent of heart tissue was destroyed, compared with 10 percent in those who received a placebo.
Researchers said the study was the first to test the effectiveness of administering the treatment at the first signs of a threatening heart attack, rather than waiting for a diagnosis to be confirmed at the hospital, which can take hours.
The study was funded by the National Institutes of Health.
"We've done a lot of studies of acute cardiac care in emergency departments and hospitals, but more people die of heart attacks outside the hospital than inside the hospital," said Dr. Harry Selker of Tufts Medical Center, who led the study. "We wanted to direct our attention to those patients."
Although 23 percent of suspected heart attacks in the study turned out to be false alarms, the treatment did not appear to have any harmful effect on those patients, the researchers said.
The treatment costs about $50.
"We wanted to do something that is effective and can be used anywhere," Selker said.
(Reporting By Susan Kelly; Editing by Gerald E. McCormick)