Serious Advancement in Medical Science

[Kyronea]

http://www.msnbc.msn.com/id/18368186/site/newsweek/

Docs Change the Way They Think About Death
The new science of resuscitation is changing the way doctors think about heart attacks—and death itself.
By Jerry Adler
Newsweek

May 7, 2007 issue - Consider someone who has just died of a heart attack. His organs are intact, he hasn't lost blood. All that's happened is his heart has stopped beating—the definition of "clinical death"—and his brain has shut down to conserve oxygen. But what has actually died?

As recently as 1993, when Dr. Sherwin Nuland wrote the best seller "How We Die," the conventional answer was that it was his cells that had died. The patient couldn't be revived because the tissues of his brain and heart had suffered irreversible damage from lack of oxygen. This process was understood to begin after just four or five minutes. If the patient doesn't receive cardiopulmonary resuscitation within that time, and if his heart can't be restarted soon thereafter, he is unlikely to recover. That dogma went unquestioned until researchers actually looked at oxygen-starved heart cells under a microscope. What they saw amazed them, according to Dr. Lance Becker, an authority on emergency medicine at the University of Pennsylvania. "After one hour," he says, "we couldn't see evidence the cells had died. We thought we'd done something wrong." In fact, cells cut off from their blood supply died only hours later.

But if the cells are still alive, why can't doctors revive someone who has been dead for an hour? Because once the cells have been without oxygen for more than five minutes, they die when their oxygen supply is resumed. It was that "astounding" discovery, Becker says, that led him to his post as the director of Penn's Center for Resuscitation Science, a newly created research institute operating on one of medicine's newest frontiers: treating the dead.

Biologists are still grappling with the implications of this new view of cell death—not passive extinguishment, like a candle flickering out when you cover it with a glass, but an active biochemical event triggered by "reperfusion," the resumption of oxygen supply. The research takes them deep into the machinery of the cell, to the tiny membrane-enclosed structures known as mitochondria where cellular fuel is oxidized to provide energy. Mitochondria control the process known as apoptosis, the programmed death of abnormal cells that is the body's primary defense against cancer. "It looks to us," says Becker, "as if the cellular surveillance mechanism cannot tell the difference between a cancer cell and a cell being reperfused with oxygen. Something throws the switch that makes the cell die."

With this realization came another: that standard emergency-room procedure has it exactly backward. When someone collapses on the street of cardiac arrest, if he's lucky he will receive immediate CPR, maintaining circulation until he can be revived in the hospital. But the rest will have gone 10 or 15 minutes or more without a heartbeat by the time they reach the emergency department. And then what happens? "We give them oxygen," Becker says. "We jolt the heart with the paddles, we pump in epinephrine to force it to beat, so it's taking up more oxygen." Blood-starved heart muscle is suddenly flooded with oxygen, precisely the situation that leads to cell death. Instead, Becker says, we should aim to reduce oxygen uptake, slow metabolism and adjust the blood chemistry for gradual and safe reperfusion.

Researchers are still working out how best to do this. A study at four hospitals, published last year by the University of California, showed a remarkable rate of success in treating sudden cardiac arrest with an approach that involved, among other things, a "cardioplegic" blood infusion to keep the heart in a state of suspended animation. Patients were put on a heart-lung bypass machine to maintain circulation to the brain until the heart could be safely restarted. The study involved just 34 patients, but 80 percent of them were discharged from the hospital alive. In one study of traditional methods, the figure was about 15 percent.

Becker also endorses hypothermia—lowering body temperature from 37 to 33 degrees Celsius—which appears to slow the chemical reactions touched off by reperfusion. He has developed an injectable slurry of salt and ice to cool the blood quickly that he hopes to make part of the standard emergency-response kit. "In an emergency department, you work like mad for half an hour on someone whose heart stopped, and finally someone says, 'I don't think we're going to get this guy back,' and then you just stop," Becker says. The body on the cart is dead, but its trillions of cells are all still alive. Becker wants to resolve that paradox in favor of life.

This is amazing, to put it simply...it provides startling new evidence for cryogenics alone, not to mention the sheer benefits for saving lives in a traditional matter this presents.

The key, however, will be taking advantage of this and resucitating people without accidentely killing them. Since it is the re-introduction of oxygen that does it, we need a method of re-introducing oxygen far more slowly so we don't kill them.

[Beeyo]

Wow.

[Chrono'99]

Wow. Instead of reviving people, we were killing them a second time? o_O

[Beeyo]

Like I said. Wow.
This shows that, even though we've made a whole lot of progress studying damn near everything on this planet, we still know shit.
I'll leave all the technical talk up to smarter guys in this Compendium, but this is an astounding find.

[Kyronea]

Wow. Instead of reviving people, we were killing them a second time? o_O

Yep. Basically an immune response; the cells see the sudden introduction of oxygen as cancerous and immediately deny it all and shut down everything, thus killing the person. It's sad, really, how many people might have been saved. Still, rather than dwell on that, we simply must figure out a way to get around this, and we will be reviving a hell of a lot more people than we used to.

[Chrono'99]

   Overall, we can reverse the
   old maxim and say that where
   there is no death there will
   be life...

[Paleontole]

Interesting stuff

[cronopolis]

Being able to resussitate people in such mannor would allow for the development of interplanetary or even intergalactic travel because you could be put in bio stasis and conserve the bulk of the provisions thus allowing for longer distances to be reached in space
That means that we could explore the other star systems in search of intellegent life...I think I hear a new season of space based shows

[Mystic Frog King]

Being able to resussitate people in such mannor would allow for the development of interplanetary or even intergalactic travel because you could be put in bio stasis and conserve the bulk of the provisions thus allowing for longer distances to be reached in space
That means that we could explore the other star systems in search of intellegent life...I think I hear a new season of space based shows

...

Does that even deserve a response? A friendly 'no', maybe?

[Lu Su]

sorry to rain on your parade but although the body could survive a short period of time anything more than ten minutes and you would have a living corpse devoid of brain activity due to how fast brain damage occurs after losing O2 for more than five minutes
      also it would be useless if you died of old age due to the fact that wearing of the cells due to respiration, in other words O2 is part of the reason we die  

[Kyronea]

Being able to resussitate people in such mannor would allow for the development of interplanetary or even intergalactic travel because you could be put in bio stasis and conserve the bulk of the provisions thus allowing for longer distances to be reached in space
That means that we could explore the other star systems in search of intellegent life...I think I hear a new season of space based shows

...

Does that even deserve a response? A friendly 'no', maybe?

Though written poorly, he is correct...as I stated in the original post, this has startling revelations for the advancement in cryogenics, which would make stasis pods of the manner he speaks of far more technologically within our reach....but frankly I doubt they would be used in such a manner for space travel. Far more likely is a generational ship.

sorry to rain on your parade but although the body could survive a short period of time anything more than ten minutes and you would have a living corpse devoid of brain activity due to how fast brain damage occurs after losing O2 for more than five minutes

That's not what the research states. Read the article instead of making uninformed responses based on prior medical knowledge, or else you look like people who saw the Wright Brother's airplane footage and state that heavier than air flight is impossible. (Not to offend; simply friendly advice.)

[Mystic Frog King]

Being able to resussitate people in such mannor would allow for the development of interplanetary or even intergalactic travel because you could be put in bio stasis and conserve the bulk of the provisions thus allowing for longer distances to be reached in space
That means that we could explore the other star systems in search of intellegent life...I think I hear a new season of space based shows

...

Does that even deserve a response? A friendly 'no', maybe?

Though written poorly, he is correct...as I stated in the original post, this has startling revelations for the advancement in cryogenics, which would make stasis pods of the manner he speaks of far more technologically within our reach....but frankly I doubt they would be used in such a manner for space travel. Far more likely is a generational ship.

sorry to rain on your parade but although the body could survive a short period of time anything more than ten minutes and you would have a living corpse devoid of brain activity due to how fast brain damage occurs after losing O2 for more than five minutes

That's not what the research states. Read the article instead of making uninformed responses based on prior medical knowledge, or else you look like people who saw the Wright Brother's airplane footage and state that heavier than air flight is impossible. (Not to offend; simply friendly advice.)

It's more the fact that it isn't directly linked to space travel yet he seemed to imply it was. Also the way he put it sounded so Dr. Who I thought I'd throw up =/

I'm no expert, but isn't he right? Regardless of whether the body is dead or not, the brain still has no oxygen and as such it will be damaged... sorry if I'm getting this wrong =/

[Kyronea]

It's more the fact that it isn't directly linked to space travel yet he seemed to imply it was. Also the way he put it sounded so Dr. Who I thought I'd throw up =/

Dr. Who? Wouldn't have been my first thought. I'm guessing you're not a science fiction fan.

I'm no expert, but isn't he right? Regardless of whether the body is dead or not, the brain still has no oxygen and as such it will be damaged... sorry if I'm getting this wrong =/

...yes, potentially, now that I reread the article, as it mentions methods of keeping oxygen flowing to the brain without triggering the automatic anti-cancer response. To be frank, I'm not a doctor nor a biologist so you can't take my word for it. All I can suggest is more research into the matter, which I will perform and will update this thread as needed.

[Mystic Frog King]

It's more the fact that it isn't directly linked to space travel yet he seemed to imply it was. Also the way he put it sounded so Dr. Who I thought I'd throw up =/

Dr. Who? Wouldn't have been my first thought. I'm guessing you're not a science fiction fan.

I'm no expert, but isn't he right? Regardless of whether the body is dead or not, the brain still has no oxygen and as such it will be damaged... sorry if I'm getting this wrong =/

...yes, potentially, now that I reread the article, as it mentions methods of keeping oxygen flowing to the brain without triggering the automatic anti-cancer response. To be frank, I'm not a doctor nor a biologist so you can't take my word for it. All I can suggest is more research into the matter, which I will perform and will update this thread as needed.

I'm a big science fiction fan. But I don't like it when people bring it into real life science. 'Bio stasis' sounds so science fiction...

Ah...

[Kyronea]

I'm a big science fiction fan. But I don't like it when people bring it into real life science. 'Bio stasis' sounds so science fiction...

Ah...

The whole idea of science fiction is to take scientific concepts and apply them to fictional situations. Remember, the very method we are using to communicate was once naught but science fiction, as was the idea of space travel, or computers that could fit on a desktop, or portable computers, or most of our recent medical knowledge, ect ect.

So, while "bio stasis" might sound like science fiction, discoveries such as this make it possible to be science fact.