title: Setting Up an Efficient Therapeutic Hypothermia Team in Conscious ST Elevation Myocardial Infarction Patients: A UK Heart Attack Center Experience.
abstract: Patients presenting with ST elevation myocardial infarction (STEMI) are routinely treated with percutaneous coronary intervention to restore blood flow in the occluded artery to reduce infarct size (IS). However, there is evidence to suggest that the restoration of blood flow can cause further damage to the myocardium through reperfusion injury (RI). Recent research in this area has focused on minimizing damage to the myocardium caused by RI. Therapeutic hypothermia (TH) has been shown to be beneficial in animal models of coronary artery occlusion in reducing IS caused by RI if instituted early in an ischemic myocardium. Data in humans are less convincing to date, although exploratory analyses suggest that there is significant clinical benefit in reducing IS if TH can be administered at the earliest recognition of ischemia in anterior myocardial infarction. The Essex Cardiothoracic Centre is the first UK center to have participated in administering TH in conscious patients presenting with STEMI as part of the COOL-AMI case series study. In this article, we outline our experience of efficiently integrating conscious TH into our primary percutaneous intervention program to achieve 18 minutes of cooling duration before reperfusion, with no significant increase in door-to-balloon times, in the setting of the clinical trial.
authors.affiliation: 1 Post-Graduate Medical Institute, Anglia Ruskin University , Chelmsford, United Kingdom .|2 Department of Cardiology, The Essex Cardiothoracic Centre (CTC) , Basildon, United Kingdom .
authors.forename: Shahed
authors.initials: S
authors.lastname: Islam
authors.affiliation: 1 Post-Graduate Medical Institute, Anglia Ruskin University , Chelmsford, United Kingdom .
authors.forename: James
authors.initials: J
authors.lastname: Hampton-Till
authors.affiliation: 1 Post-Graduate Medical Institute, Anglia Ruskin University , Chelmsford, United Kingdom .|2 Department of Cardiology, The Essex Cardiothoracic Centre (CTC) , Basildon, United Kingdom .
authors.forename: Shah
authors.initials: S
authors.lastname: MohdNazri
authors.affiliation: 1 Post-Graduate Medical Institute, Anglia Ruskin University , Chelmsford, United Kingdom .|2 Department of Cardiology, The Essex Cardiothoracic Centre (CTC) , Basildon, United Kingdom .
authors.forename: Noel
authors.initials: N
authors.lastname: Watson
authors.affiliation: 2 Department of Cardiology, The Essex Cardiothoracic Centre (CTC) , Basildon, United Kingdom .
authors.forename: Ellie
authors.initials: E
authors.lastname: Gudde
authors.affiliation: 2 Department of Cardiology, The Essex Cardiothoracic Centre (CTC) , Basildon, United Kingdom .
authors.forename: Tom
authors.initials: T
authors.lastname: Gudde
authors.affiliation: 1 Post-Graduate Medical Institute, Anglia Ruskin University , Chelmsford, United Kingdom .
authors.forename: Paul A
authors.initials: PA
authors.lastname: Kelly
authors.affiliation: 1 Post-Graduate Medical Institute, Anglia Ruskin University , Chelmsford, United Kingdom .
authors.forename: Kare H
authors.initials: KH
authors.lastname: Tang
authors.affiliation: 1 Post-Graduate Medical Institute, Anglia Ruskin University , Chelmsford, United Kingdom .|2 Department of Cardiology, The Essex Cardiothoracic Centre (CTC) , Basildon, United Kingdom .
authors.forename: John R
authors.initials: JR
authors.lastname: Davies
authors.affiliation: 1 Post-Graduate Medical Institute, Anglia Ruskin University , Chelmsford, United Kingdom .|2 Department of Cardiology, The Essex Cardiothoracic Centre (CTC) , Basildon, United Kingdom .
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Keeble
mesh_terms: D001833:Body Temperature Regulation; D003243:Consciousness; D019091:Critical Pathways; D003695:Delivery of Health Care / Q000458:organization & administration*; D017598:Efficiency, Organizational; D004739:England; D005240:Feasibility Studies; D006801:Humans; D007036:Hypothermia, Induced; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D010348:Patient Care Team / Q000458:organization & administration*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome