Cooling therapy helps get Australian visitor home alive

Process slows brain cell death during cardiac arrest

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CEDAR RAPIDS — Brian Nowland chose the right place to “die.”

The Australian man was visiting his son’s family in Marion when he suffered a cardiac arrest, in which the heart stops beating.

Pushing cars out of the snow during December’s blizzard precipitated his heart attack, but Nowland, 57, credits a cooling therapy for his renewed healthy outlook.

Transported by ambulance to St. Luke’s Hospital in Cedar Rapids, Nowland was placed under blanket-like wraps infused with cold water, which lowered his body temperature to between 91.4 degrees and 93.2 degrees, said Jenny Houlihan, nurse manager for the hospital’s Cardiac Care Unit. Normal body temperature averages 98.6 degrees.

Houlihan said St. Luke’s has used the cooling process, known as therapeutic hypothermia, since 2003. Of 20 patients who underwent the therapy last year, nine — or 45 percent — survived to leave the hospital neurologically intact, she said.

That compares to success rates before the therapy of just 10 percent to 15 percent, said Dr. Todd Langager of Cardiologists LC in Cedar Rapids.

Langager said the therapy slows the body’s metabolism, decreasing the rate of brain cell death caused by lack of oxygen. After 24 hours, Nowland’s body temperature was gradually rewarmed to normal.

The process played a significant role in Nowland’s recovery, Langager said, but other factors were equally critical. He pointed to the actions of Sam Nowland, 29, who performed CPR on his father until first responders arrived.

Paramedics used a defibrillator to restart Nowland’s heart and brought him to St. Luke’s through the blizzard, where the medical team started the hypothermia therapy.

He underwent triple bypass surgery on Dec. 28.

“For all of those reasons, this gentleman is going to be able to go back home alive,” Langager said.

Getting ready to leave the hospital last week, Nowland said he remembers nothing of what happened Dec. 20, when snow began falling in Eastern Iowa.

Nowland had played with his granddaughters, Kaiya, 3 months, and Lilly, 2, and helped dig cars out of the snow, said his wife, Mary.

The couple had traveled to Iowa from their home in Tamworth, Australia, about five hours north of Sydney, where snow is a rarity.

Nowland works in education and has seldom taken a sick day in his career, his wife said.

“He’s always been very healthy and fit,” she said. “He’d still outrun the young ones in cricket.”

Nowland was waiting when his son got home from his job at Four Oaks about 10:30 p.m. Sam Nowland talked to his father and had turned around when he heard him fall off his chair.

Unsure of what happened, but unable to find a pulse, Sam started CPR, which he had learned in high school and been recertified for his job.

“You were clinically dead for 20 minutes,” he told his father last week, relaying the series of events in his dad’s hospital room.

Medical travel insurance is covering the health care expenses.

Because of the distance to Sydney — site of the nearest hospital likely to provide the therapy — Mary Nowland said her husband would likely have died had he suffered cardiac arrest at home.

Langager said time is vital to initiating the treatment.

“Everything came together,” he said. “It turned out that this vacation may well have saved his life.”

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