N.M. Doctors Study Way to 'Buy Time' for Heart Attack Patients

Patients are half as likely to suffer cardiac arrest if they're given special IV solution.


 
 

Olivier Uyttebrouck, Albuquerque Journal Staff Writer | | Thursday, April 26, 2012


Heart attack patients are half as likely to suffer cardiac arrest or death if paramedics give them an IV solution of glucose, insulin and potassium during transport to the hospital, according to a large study performed in New Mexico and other sites. Patients who received the inexpensive solution also experienced less damage to the heart than those who received a placebo, according to a study published March 28 in the Journal of the American Medical Association.

If the treatment is approved for routine practice, it could offer paramedics a new tool for minimizing the worst consequences of a heart attack, medical officials said.

"The thing we're trying to do is save heart muscle tissue," said Kurt Krumperman, executive director of Albuquerque Ambulance Service, which participated in the three-year study.

The glucose-insulin-potassium solution "has the potential to prevent heart muscle damage at the cellular level," he said. "It offers the promise of preventing the damage from being as bad." Each year, about 785,000 Americans have a first heart attack and an additional 470,000 have a second or subsequent heart attack, according to the Centers for Disease Control and Prevention. Heart disease is the nation's leading cause of death, resulting in one in four U.S. deaths.

A heart attack is caused by a blocked artery that deprives the heart of blood and oxygen.

The glucose-insulin solution minimizes muscle damage by providing the heart with a usable source of energy until physicians can treat the cause of the heart attack, said Dr. Michael Richards, chairman of University of New Mexico Hospital's department of emergency medicine and a co-author of the study.
Insulin helps the heart absorb the glucose and potassium is an electrolyte crucial to muscle function.

"It's designed to buy a little more time," Richards said. The solution "decreases the risk of having a bad outcome."

The solution itself costs about $50 per patient, the study estimated. The solution does not require U.S. Food and Drug Administration approval, Richards said, but medical professionals are unlikely to adopt it as a standard practice before a larger study is performed, he said.

The study was based on the outcomes of 871 patients recruited by paramedics with 36 emergency medical systems in the U.S. from 2008 to 2011. Emergency personnel in Bernalillo and Sandoval counties recruited 187 patients for the study, Richards said. Nearly half the patients received an intravenous solution that contained 30 percent glucose. The other patients received a placebo.

The worst outcome of a heart attack is cardiac arrest, in which the heart stops beating, often resulting in death. Of the 871 patients enrolled in the study, 58 experienced cardiac arrest or death, according to the study.

Among patients who received the glucose-insulinpotassium solution, 4.4 percent experienced cardiac arrest or death - a rate about half that of patients who received the placebo, the study reported.

A 30-day follow-up exam found that patients who received the glucose-insulinpotassium solution had significantly less damage to the left ventricle - the crucial chamber of the heart that pumps blood to the body.

The solution was not able to entirely prevent permanent damage to the heart, or myocardial infarction, Richards said.

"But if you were actually having an infarction, the (glucose-insulin-potassium solution) decreased the size of the heart attack, and it decreased your risk of dying or having a cardiac arrest," he said. A pump similar to this one was used by paramedics to deliver an intravenous solution of glucose, insulin and potassium to heart attack patients en route to the hospital.



Copyright © 2013 LexisNexis, a division of Reed Elsevier Inc. All rights reserved. Terms and Conditions | Privacy Policy


Connect: Have a thought or feedback about this? Add your comment now
Related Topics: News

What's Your Take? Comment Now ...

Featured Careers & Jobs in EMS





 

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Innovation & Progress

Follow in the footsteps of these inspirational leaders of EMS.
More >

Multimedia Thumb

Four Killed in New Mexico Medical Plane Crash

Crash near fairgrounds claims patient and crew of three.
Watch It >


Multimedia Thumb

Texas Ambulance Involved in Crash

Odessa ambulance and car collide during response.
Watch It >


Multimedia Thumb

Las Vegas Fire, AMR Reach New Deal

Tentative agreement reached over ambulance calls.
Watch It >


Multimedia Thumb

Fire Damages Several Homes in California Earthquake

Four homes destroyed and others damaged after quake rattles Napa.
Watch It >


Multimedia Thumb

Where in the World of EMS is A.J.? Scranton

JEMS Editor-in-Chief visits his hometown of Scranton, Pa.
More >


Multimedia Thumb

Over 100 Injured in California Earthquake

172 patients treated at Napa hospital after 6.0-magnitude earthquake.
More >


Multimedia Thumb

Numerous Rescues during Arizona Flooding

Severe flooding across the region prompted several rescues.
More >


Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


Multimedia Thumb

The AmbuBus®, Bus Stretcher Conversion Kit - EMS Today 2013

AmbuBus®, Bus Stretcher all-hazards preparedness & response tool
Watch It >


More Product Videos >