‘Suspended Animation’: Can cooling human bodies to super low
Imagine you are shot or stabbed and losing a massive amount of blood.

Simply put, your chances of survival with ongoing blood loss are slim: the likely outcome from such serious trauma is profound shock ending in cardiac arrest (the heart stops beating).

But an experimental technique that drastically lowers core body temperature in victims who have or are about to suffer a cardiac arrest could extend the window of time for trauma surgeons to repair severe and life threatening injuries.

According to a report in New Scientist last week, a team of trauma surgeons led by Dr. Samuel Tisherman at the University of Maryland School of Medicine are the first to utilize such a technique that effectively places a human into a unique state, akin to “suspended animation”.

By inducing profound hypothermia (lowering the core body temperature), the heart, brain and other critical organs are placed into such a “standby mode”, in which they do not require nearly as much oxygen, limiting damage to cells and organs.

Formally known as Emergency Preservation and Resuscitation (EPR), the goal is to rapidly cool victims of trauma who have, or are likely to suffer a cardiac arrest (due to ongoing blood loss), by replacing their entire blood volume with ice-cold saline (salt water).

The temperature achieved with this technique is bone chilling—dropping the body’s core temperature to about 50 degrees Fahrenheit (normal body temp is 98.6 Fahrenheit) via an ice-cold saline solution injected into the aorta, the major blood vessel leaving the heart that supplies blood to the rest of the body.

This induced state of hypothermia effectively places the body into a state of suspended animation, almost a type of “standby mode”. In this state, the body’s metabolism drastically decreases, and our cells do not require as much oxygen, significantly reducing the potential for cellular damage.

The rationale is that this approach may allow extra time for surgeons to gain control of bleeding, followed by delayed resuscitation with cardiopulmonary bypass (a specialized machine that filters the blood and returns it to the patient).

Tisherman and his colleagues have already performed the procedure on at least one patient and plan to report results next month, according to the report in New Scientist.

But the long term goal is to compare EPR in an upcoming trial to standard resuscitation which would typically involve a procedure known as emergency department (ED) thoracotomy: the chest is opened with a surgical incision, the aorta (large blood vessel coming out of the heart) is cross clamped to increase blood flow to the brain, followed by open cardiac massage (manually compressing the heart to generate blood flow) .

His plan is to compare outcomes of 10 persons undergoing EPR with another 10 individuals who undergo standard resuscitation. The FDA has approved the trial obviating the need for patient consent since the injuries are presumably fatal with no alternative options for treatment.

The ED thoracotomy is a last ditch effort to save a patient of penetrating trauma who loses “signs of life”— pulse and blood pressure–when they arrive in the emergency department. Overall survival from such a procedure is about 10-13% in most studies, with neurologically intact survival abysmally low (2%).

Source: https://www.forbes.com/sites/robertglatter/2019/11/25/suspended-animation-can-cooling-our-bodies-to-super-low-temperatures-save-us-after-deadly-trauma-and-blood-loss/#7660722257c7
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Dr. S●●●●r D●●●i
Dr. S●●●●r D●●●i General Medicine
Very interesting article on emergency trauma care.Dr.Sudhir Desai.
Nov 27, 2019Like
Dr. s●●●●p s●●●●●●●●●a
Dr. s●●●●p s●●●●●●●●●a Oral and Maxillofacial Surgery
Induced hypothermia, obviously great as a last resort but patient may face comatose condition.
Nov 28, 2019Like