Question

Dear Friend, We are very sorry about the loss of your father. Please accept our sincere sympathy.

The following reply is from Michael Sayre, MD, an emergency physician from The Ohio State University Medical Center. Dr. Sayre, a leading expert on sudden cardiac arrest research, serves as Chairman of our Board of Directors.

"I am sorry for the loss of your father. Unfortunately, the story you told happens all too commonly across the US. One of the reasons for the Sudden Cardiac Arrest Foundation is to promote more effective treatments for cardiac arrest so that more lives can be saved.

During resuscitation from cardiac arrest, many patients have a pulse restored and then lose it a short time later. A shock from a defibrillator will usually eliminate ventricular fibrillation, but the problem that caused the cardiac arrest is often still present. For example, if the victim was having a heart attack due to a blockage in a coronary artery and the heart attack led to the ventricular fibrillation, the coronary artery will still be blocked after the shock from the defibrillator. The problem may be so severe as to shortly lead to another episode of cardiac arrest. At present, there is no rapidly available way to support the patient who is having a catastrophic event like that.

Many researchers have ideas about novel treatment methods for catastrophic causes of cardiac arrest, but the ideas need to be critically evaluated. That evaluation is time consuming and expensive, and resources are limited. We need more help from government and interested individuals to find effective treatments and get them out of the lab and into the ambulance."

Dear Friends,

First may I extend my deepest sympathy to kkvaidya and family.

 My husband survived a cardiac arrest in 1995 at the age of 47.  After CPR and being shocked with the defribrillator multiple times the surgeons performed a quadruple bypass, during which time he suffering a stroke. Having survived all of this he looks like the picture of health and works hard to keep his health up as best as he can. He did however suffer cerebral inoxia. I would like very much for this part of the problem to be addressed. We are all so fourtunate to have this technology available to save lives, understandably for now there are not that many survivors. My question is what is being done to follow those that have survived? Are there follow up studies and how do we deal with the problems associated with cerebral inoxia?

Dear "Life After 33 Minutes,"

I was glad to learn that your husband survived his cardiac arrest. Unfortunately, there are commonly subtle brain injuries that occur during the cardiac arrest when there is little or no blood flow to the brain. Since blood carries oxygen, the period of time without blood flow during cardiac arrest leads to cerebral anoxia. Certain parts of the brain are quite sensitive to anoxia and are injured even though most of the brain recovers well. The person with this problem may be awake and able to move normally, but is "just not the same as before the cardiac arrest."

I know that many patients and their loved ones struggle with the changes in personality that occur when those areas of the brain are damaged. These injured parts are often those responsible for "executive functioning" or things like motivation or staying on task. If the survivor of cardiac arrest has injured the area of the brain responsible for providing motivation, the family can struggle with trying to get the patient to attend treatment and work hard enough to get better since the patient is just not that interested.

Amazing things are happening in rehabilitation from stroke in the past few years. Stroke, like cardiac arrest, also causes cerebral anoxic injury. Perhaps you have already seen someone who is an expert in stroke rehabilitation; but if not, a consultation with a stroke rehabilitation expert in your area might be helpful.

Michael Sayre, MD