Thursday, September 13, 2007

saline for spinal injuries?


An experimental procedure performed on Buffalo Bills tight end Kevin Everett in the ambulance minutes after he sustained a spinal-cord injury during Sunday's game might have played a crucial role in what doctors say is his surprising progress.

The quick infusion into a vein, via a catheter, of cold saline solution may have helped stabilize the injury, minimizing cell death and damaging inflammation, say doctors at The Miami Project to Cure Paralysis, where the procedure was developed.

Everett's injury initially sparked fears he might never again walk, but his doctors said Wednesday that he is moving his arms and legs voluntarily and no longer requires the help of a ventilator to breathe.

Miami Project neurosurgeon Barth Green, who has been consulting with Everett's doctors, said the procedure might have prevented paralysis.

Mild therapeutic cooling is used in many hospitals to treat heart attacks and is being experimentally used at The Miami Project and elsewhere to treat spinal-cord and brain injury. But it needs to be initiated early, and its use with Everett is "the earliest ever recorded treatment," Green said. "It was within minutes of his injury. When I heard that, it was a big goose bump, because I knew he had a good chance of recovering because I knew the earlier you apply the hypothermia the more effective it is."

The early treatment was possible because Everett's doctor, orthopedic surgeon Andrew Cappuccino, had attended a lecture where Miami Project researchers described the process. (Coincidentally, Bills owner Ralph Wilson is a major financial supporter of The Miami Project, Green said.)

When Everett was injured Sunday, Cappuccino "was there on the field immediately and it just came to his mind." He phoned The Miami Project, Green said, "and he was able to get a very sophisticated piece of equipment that keeps the temperature very accurately controlled at about 92 degrees Fahrenheit. And he did that for 48 hours."

W. Dalton Dietrich, scientific director at The Miami Project, part of the University of Miami School of Medicine, said scientists at the center have been researching it for 15 to 20 years. "We have shown that modest cooling (3 to 5 degrees Fahrenheit) is protective and improves outcome."

But it needs to be given as early as possible, he said. "The window of opportunity to introduce hypothermia may be relatively short," he said.

By Gary Mihoces and Anita Manning