Saving stroke victims from brain damage... in a ‘wine cooler’ suit

STROKE patients are being wrapped in a high-tech ‘wine cooler’ in an effort to protect them from devastating brain damage. British neurologists are involved in a major international trial to prove that cooling the body after a stroke is ‘neuro-protective’, reducing the number of brain cells that die.

A stroke occurs when the blood supply to a part of the brain is cut off. It can be caused either by a blood clot, known as an ischemic stroke, or a burst blood vessel in or around the brain, which is called a haemorrhagic stroke.

A stroke can lead to brain injury, disability or even death. Many of those who suffer serious brain damage never fully recover.

In an attempt to limit the damage done, the new procedure sees a patient’s body temperature lowered rapidly using an ice-cold IV drip, after which a padded ‘body suit’ containing chilled liquid is worn to maintain the low temperature.

Currently, a patient admitted for an ischemic stroke will be given a ‘clot-busting’ drug treatment called thrombolysis, or other bloodthinners to dissolve the clot.

As part of the new trial, British patients in Edinburgh and London are being recruited to demonstrate that lowering the body temperature stops a chemical cascade of toxins that develop when the brain is damaged by a clot.

As part of the trial, the ‘wine cooler’ treatment has to be done a maximum of three hours after arriving at hospital, and involves lowering the body temperature to between 34C and 35C as well as administering clot-busting drugs.

As the ‘wine cooler’ suit alone does not lower the body temperature quickly enough, the first step is an ice-cold saline solution IV drip.

In order not to cause any additional damage, the body’s temperature is monitored as it cools to make sure it does not go too low.

After this, the body suit – a vest and thigh pads – is wrapped around the patient and filled with cold liquid via tubes attached to a machine.

The ‘wine cooler’ suit maintains the body at 34C to 35C for about six hours. Cardiologists are already using the same science to protect the brain after a heart attack, when low oxygen levels caused by reduced blood flow can result in brain damage.

In 2002, two US studies found that heart-attack patients whose bodies were cooled had improved survival rates – and that their brains functioned better in the months following the cardiac arrest.

The results were so compelling that the American Heart Association recommended implementing hypothermia in the comatose survivors of cardiac arrest.

The trial into using the cooling technique on stroke patients involves 1,500 people in 80 hospitals across 21 countries, including the UK. Patients are given either the existing standard treatment – clotbusting drugs – or both the drugs and the ‘wine cooler’ suit.

Dr Richard Perry is the clinical lead of the Hyperacute Stroke Research Centre at University College London Hospitals (UCLH), one of the leading centres for the trial in the UK.

He says: ‘Cooling has huge potential to save people who have suffered stroke from damaging paralysis and speech impairment. At one time we had very little to treat strokes – then came clot-busting drugs which have made a huge impact. But we need to do better.’

ONE of those treated with cooling is Mark Harwood, 57, an accountant from London who suffered a stroke while in the back of a taxi. He said: ‘I started feeling lightheaded in the cab and had difficulty using my phone.

‘I had to get out, and after I staggered along the street I was eventually able to call an ambulance and was taken to UCLH.

‘Paralysis set in down my right side, I couldn’t move my arm or leg and I was having difficulty speaking. After a while I was put on a drip to deliver the clot-busting treatment and then Dr Perry arrived and explained that he would like to put me on the cooling trial.’

Mr Harwood, a father of two, wore the suit for more than six hours before being allowed to warm up again. By then his stroke was starting to subside and he had regained movement in his arm and leg.

Two months after the stroke, Mr Harwood is back at work.

He says: ‘I’m still not quite as steady as I was on my feet, but I’m getting back to normal fairly quickly.’

Patients are being recruited into the trial until it closes next year. It is likely to be 2018 before the results are published.