New and improved techniques to treat cardiac arrest

Professor of Emergency Medicine at the University of Pennsylvania School of Medicine, has been named Director of Penn's new Center for Resuscitation Science.

The Center will focus on cellular research to aid in developing new and improved techniques to treat cardiac arrest. The Center will consist of three full-time labs and a clinical and administration branch.

“I believe this Center has the potential to save lives and to revolutionize emergency patient care,” said Becker, who was recruited from the University of Chicago Hospital to lead the Center. “My goal is to make resuscitation medicine a specialty like trauma or critical care.”

Dr. Becker's previous contributions to cardiac care include the development of the automatic external defibrillator (AED). The AED is a device that delivers a shock to restart the heart of a person in cardiac arrest that can be used by non-medically trained personnel.

Initially, Dr. Becker's new research will focus on extending the five-minute window associated with successful cardiac arrest resuscitation.

“If I can get a cardiac arrest patient in front of me within five minutes, I have a good chance of saving them,” said Becker. “But the chances of that are slim due to the average response time of Emergency Medical Services, which tend to take between 10-20 minutes to get you to a hospital. The thrust of my work is to take that five minutes and stretch it into 15 minutes.”

Dr. Becker's previous research has indicated the possibility of extending the window.

When a person has a heart attack, their cells are deprived of oxygen. So Dr. Becker began studying oxygen deprivation in cells.

“What we found when we studied oxygen deprivation in cells astounded us,” explained Becker. “When cells are deprived of oxygen for an hour there is only 4% cell death. After four hours, cell death is only around 16%. Both of these numbers are low. The amazing thing was once we re-introduced oxygen to the cells they died off rapidly to almost 60% cell death. This re-oxygenation injury we termed reperfusion injury. We concluded that the re-introduction of oxygen must be handled carefully for the majority of cells to survive. Our studies will be concentrating on ways to prepare cells deprived of oxygen for the re-introduction of oxygen.”

Dr. Becker's group will also study the benefits of cooling cardiac arrest patients. Previous studies have indicated that cooling a patient immediately after arrest noticeably improves cell death rates and resuscitation success. Recently, the American Heart Association recommended that every cardiac arrest patient who qualifies should be cooled.

“We have developed a whole program on why cooling saves cells,” said Becker. “Immediate cooling cardiac arrest victims increased their survival by 16%. That's a very significant improvement which could mean thousands of lives saved each year as we get faster and better at cooling patients. Unfortunately, we don't know exactly how cooling saves cells, so we will definitely be doing cellular experiments on the mechanisms of how cooling works. The one thing we do know from our lab, the best results require rapid cooling, yet we don't have a good way to rapidly cool patients.”

To develop more rapid cooling methods the Center for Resuscitation Science will continue to develop a novel cold slurry - a slushy mixture of salt and ice crystals - that can be injected intravenously for rapid internal cooling.

“Our current methods of cooling are far too slow,” said Becker. “Injecting bio-compatible cold slurry is the best way to rapidly drop internal temperature.”
Eventually, the goal is to create a slurry-delivery device that both medically and non-medically trained people could use on cardiac arrest patients to keep them cool during transport to a hospital.

“I don't think the full benefits of cooling on humans have been discovered yet,” continued Becker. “I'm looking forward to working with the team to find the best ways to rapidly cool patients.”

While Dr. Becker may be an expert in finding cardiac care solutions, he will also be working on ways to extend brain function during periods of resuscitation.
“Many of the things we see in the heart, are also true in the brain and the focus of our new Center is to save both the heart and the brain. Therapies for the heart may be adapted to work on the brain. I am excited because Penn offers the ability for me to work side-by-side with Penn neuroscientists to develop advanced therapies to work for both organs.”

In recognition of his many scientific contributions and international leadership, Dr. Becker was also recently elected as a member of the Institute of Medicine (IOM), one of the nations' highest honors in biomedicine.

PENN Medicine is a $2.9 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System.

Penn's School of Medicine is ranked #2 in the nation for receipt of NIH research funds; and ranked #3 in the nation in U.S. News & World Report's most recent ranking of top research-oriented medical schools. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System includes three hospitals, all of which have received numerous national patient-care honors [Hospital of the University of Pennsylvania; Pennsylvania Hospital, the nation's first hospital; and Penn Presbyterian Medical Center]; a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home care and hospice.