Hypothermia as a treatment for SCI and
Ischemia -- any type of blockage
of the blood supply -- has been used since the 1960s. But often those
treatments involved an extreme instance of hypothermia and subsequently
put patients at risk for a variety of complications, including
infection.
Dietrich and others at the Miami Project were among the
first to recognize the benefits of a more modest cooling process. "My
colleagues and I in 1987 published the first paper showing that mild
hypothermia was protective in a model of cardiac arrest in rodents,"
said Dietrich. "That paper and others in the field showed that mild
cooling was a very good therapy for ischemia, traumatic brain injury
and spinal cord injury."
According to Dietrich, cooling early after the injury was shown to improve behavior and decrease structural damage.
Dietrich told ABC News that when he saw the news break on
Everett's injury he immediately e-mailed his associate, Dr. Barth
Green, who, it turns out, is close friends with Ralph Wilson, owner of
the Buffalo Bills.
Wilson has for many years been a staunch supporter of the Miami
Project. Green quickly got into contact with Everett's physicians and
offered his experience in using hypothermia as a possible treatment,
only to find out that the therapy was already being implemented.
"Dr. Cappuccino initiated treatment very early after injury, & this is very important," Dietrich said.
Some doctors, however, are not convinced of the effectiveness of
the hypothermic treatment, and Dietrich emphasized that Everett's signs
of recovery should be attributed to a combination of therapies rather
than a single treatment. He made clear that this is an experimental
therapy, and one that is not without its shortcomings.
"The window of opportunity to introduce hypothermia may be
relatively short. Hypothermia and other treatments have to be initiated
early after injury," said Dietrich. "Thus, unless patients get to the
hospital within two to three hours, many therapies are no longer potent
in terms of targeting the injury mechanisms that they are directed
toward. & Also, cooling has in the past been somewhat difficult to
introduce."
Despite these drawbacks, Dietrich remains enthusiastic about the further avenues of treatment to which mild cooling may open.
"What's exciting about hypothermia therapy is that it
targets multiple injury mechanisms. Drugs target only specific injury
cascades, and this particular drug approach may not be the best
approach in complicated injuries such as the brain and spinal cord
injury. Thus, the advantage of mild cooling is that injury cascades
such as program cell death, inflammation, mitochondrial dysfunction and
free radical generation are all attenuated."
Asked about Everett's future, Dietrich responded, "These cases
are extremely complicated, and it will take several weeks to determine
the extent of Mr. Everett's conditions and potential for recovery of
function. Nevertheless, the information coming out in the popular news
appears to be extremely encouraging, and we all hope and pray for his
complete recovery."