LA Marathon Runner Doing Well After Hypothermia for Cardiac Arrest
In today’s LA Times Booster Shots, Jeannine Stein describes the remarkable story of LA Marathon runner Jay Yim, who suffered a heart attack around mile 18 and was rushed to the Ronald Reagan UCLA Medical Center. Today, Yim, a USC pre-med student, is in good condition and expected to make a full recovery, in part due to a new technique called induced therapeutic hypothermia.
After Yim collapsed, LAPD motorcycle officer Joshua Sewell attempted to revive him, but Yim did not have a pulse. He and another LAPD bicycle officer performed CPR until the ambulance arrived. By a twist of fate, Dr. Charles Chandler, chief of surgery at Santa Monica-UCLA Medical Center, was watching the marathon near his home and saw Officer Sewell running to the scene. He assisted the officers with CPR and talked with UCLA emergency department staff about Mr. Yim.
Dr. Paul Vespa, director of Neurocritical Care at UCLA treated Yim, and discovered that he had had a cardiac arrest plus seizures. An MRI showed brain swelling, so the hypothermia protocol was put into place. Today, Yim is undergoing physical therapy and doctors expect an excellent recovery.
The American Heart Association issued recommendations and guidelines for inducing mild hypothermia in comatose survivors of cardiac arrest. Today, about 500 out of 5,000 hospitals are performing the treatment.
When the body suffers a cardiac arrest and the heart stops, blood flow ceases and the person technically dies, says Benjamin Abella, clinical research director at the Center for Resuscitation Science in the Department of Emergency Medicine at the University of Pennsylvania. Cooling the body to between 89.6 and 93.2 degrees F, about 5-8 degrees below normal body temperature, slows brain-cell death and other organ demise that could lead to permanent neurological damage.
The cooling should be done within 30 to 60 minutes of the arrest, and the patients remain that way for 12 to 24 hours before the body is slowly rewarmed to a normal temperature.
“Therapeutic hypothermia is the only post-resuscitation therapy shown to improve both survival and reduce disability after cardiac arrest,” says Raina M. Merchant, M.D., M.S., a Robert Wood Johnson Foundation Clinical Scholar and emergency medicine physician at the University of Pennsylvania School of Medicine in Philadelphia. Dr. Merchant authored a study in the AHA journal Circulation in 2009 on the cost-effectiveness of hypothermia treatment.
Doctors are not sure if Yim will ever run a marathon again, but Officer Sewell has promised to finish the last 8.2 miles with him if he does. "I told him that, and he got a big old smile on his face," Sewell said, adding that he’s been spending a lot of time with Yim and his family. "I got a little emotionally attached to this one."