Blog

     There is a set series of events for a patient suffering cardiac arrest. The first step is recognition of what is happening. The second step is CPR to maintain oxygen flow to the body and minimize damage. The third step is defibrillation to restart the heart. The fourth step is vague. Sometimes there is a defect of the heart which causes the cardiac arrest which is then fixed with surgery. Other times medication may be able to stabilize the patient. The rest of the time, wishful thinking is administered liberally.

     There is a new, or not so new, method that is far more successful than the “sit tight” method. This old method is gaining popularity in many hospitals. The New England Journal of Medicine published a study about patients resuscitated by ventricular defibrillation after cardiac arrest. Of the patients who underwent therapeutic hypothermia, 55% had a good outcome, as far as recovery and neurological function. Of those patients who did not undergo therapeutic hypothermia, 39% had a good outcome. This study was published in 2002, so why is this method only used in 300 of 6,000 major hospitals in the U.S.? The reason is that most hospitals are simply not equipped and are slow to change. So what can you do? Be aware of the hospitals in your area that use therapeutic hypothermia.

Click here to learn about cardiac arrest

Click here to learn about therapeutic hypothermia

Click here to see the study

Click here to see some involved cities

     Although the last article was about more concrete innovations, we at Medinary are easily distracted when medical things make it into headlines. Currently, the media world is buzzing over a study that may promise a new kind of breast reconstruction following surgery. There is a new technique, currently only having been tried on pigs, that allows the body to naturally regrow breast tissue. This would be a welcome alternative to engineered implants which can rupture, shrink, etc. Human trials on six patients are planned to begin next year in Melbourne, Australia.

      The team behind the method compares it to scaffolds. They implant an empty chamber which the body fills with fat on its own. Thus, the reconstruction can be highly detailed. Another plus is that the “scaffold” is made with biodegradable material, so that removal is not necessary. The doctors responsible for it are quite realistic and not quick to call it perfect. One of the most pressing questions is if it will truly be effective in cancer patients. There is concern over whether cancer cells could use the scaffold to spread and regrow. If all goes well, as all hope it will, it could still be years before it is used clinically. Read about it at BBC.

    The Cleveland Clinic is an “academic medical center” known not only for the medical care received there but also for their work in medical research. Every year, their panel of 60 doctors select the expected top ten medical innovations of the upcoming year. Their criteria for their selections are significant clinical impact, high probability of commercial success, in or exiting clinical trial, and sufficient data to support its nomination. Although the second criteria likely eliminates some truly amazing advances, it also ensures that their top ten is not a list of what would be ideal, but what is likely.    

     The number one medical innovation for 2009 was the use of “circulating tumor cell technology“. This technology allows scientists to measure the amount of circulating tumor cells in a sample of blood, no matter how minute the number. It can show doctors whether or not a patient is at risk for developing cancer, if a patient’s cancer has metastasized, and ultimately if chemotherapy would be an effective treatment. This invention could be greatly helpful in the field of oncology.     

      The runner-up for 2009 was a warm organ perfusion device. This could be of greatest use for those in need of a heart transplant. A heart can only survive outside a human body for four hours, but with this device that simulates the conditions of the human body, the life span triples to twelve hours. This innovation will prevent waste, as hearts without the device that are not transplanted within four hours will decay and become unusable.     

     The Cleveland Clinic selected “bone conduction of sound for single-sided deafness” as the number one medical innovation for 2010. This is a hearing device that does not require surgery and conducts specific imperceptible vibrations through the teeth to help patients with single-sided deafness. Find out more about how it works here.    

     The runner-up for 2010 is simple but its effects will save many lives. It is a low-volume, low-pressure tracheal tube cuff to reduce ventilator-associated pneumonia. The airway seals used previously only sealed partially, allowing fluids to leak into the lungs. On the opposite end, they could also be set to too high a pressure and damage the trachea. This new device seals completely (and gently) and will reduce the number of cases of pneumonia in patients who require ventilators. Some of the problems caused by the now outdated tracheal tube cuffs are outlined here in a study.

     These brief summaries of only four devices/techniques show that the medical world advances every year. I hope that you will take the time out to read about a few more at the Cleveland Clinic Website.