Last update: Thursday, July 24, 2014
Radical procedure, during which the patient’s blood is replaced with chilled saline solution, is able to return to life in a state of clinical death, says correspondent Press BBC Future .
“If your body temperature 10 ⁰ C, the brain does not give signs of activity, the heart has stopped, there is no blood in the body – hardly anyone would argue with the fact that you are dead, – says researcher at Arizona State University Peter Rea. – But we can return you back to life. “
Peter Rhee is not exaggerating. Experiments that he spends with his colleague from the University of Maryland Samuel Tishermanom proved that the body clock can be maintained in a state of suspended animation. Their technique, so far tested only on animals – one of the wildest in medicine.
During this procedure, the patient is derived from whole blood, and the body is cooled by more than 20 ⁰ C. After the blood was re-injected into the body, and the body is slowly heated.
“As soon as the body is pumped blood, skin immediately turns pink, and at a certain temperature the heart activated spontaneously, – says Peter Rea. – It’s pretty interesting: at 30 ⁰ C heart starts beating itself. Later, when the body becomes hotter, it alone restores a normal rhythm. “
It is striking that the animals that performed the experiment, after returning to life evince very little sign of any side effects. “For a while they stay on their feet unsteadily, but the next day behave absolutely normal,” – said Samuel Tisherman.
Tisherman gained worldwide fame after his stated willingness to apply this method to the Pittsburgh hospital patients. According to him, it must be received bullet injuries and are in critical condition, when the heart has stopped. For such people, the proposed technique Tishermanom – the last hope.
“Cheat death hibernation” – so informed about this idea broadcaster CNN.The New York Times wrote about the method Tishermana under even more scathing headline: “Kill the patient to save his life.”
Such sensational coverage of his experiments sometimes hurts Samuel Tishermana. During the conversation, he gives the impression of thinking, weighted and seeks to present their research in a sensational light.
Scientist especially careful in using the term “suspended animation.”
“I do not care what they can tolerate inaccuracy. But when people hear this term, they think of Han Solo from” Star Wars “or space travelers, which can be frozen and sent to Jupiter, where they may live,” – he says .
“It distorts the meaning of my research. Important to understand that this is not science fiction. This theory is based on experimental work and tested in strict accordance with the scientific method before using it will save people from death,” – says Samuel Tisherman.
His research partner Peter Rhee became widely known after the treatment of the U.S. Congress member Gabrielle Giffords. In 2011, she was attacked, she was seriously wounded in the head, but doctors managed to save her.
Peter Rea bolder than Tishermana, plans to use the “salt of suspended animation.” It does not exclude the possibility of maintaining the body in this state for a long time. Although, according to him, is the distant future.”What we are doing now – this is just the initial stage of the experiment,” – he says.
“40-year-old man survived without any consequences for the brain after three and a half hours of cardio-pulmonary resuscitation “
Samuel Tisherman began to study the problem of resuscitation still in medical school, where his mentor was Peter Safar. In 1960, Safar was a pioneer in cardiopulmonary resuscitation (CPR).Now chest compressions, or chest compressions – all this known procedure: man rhythmically pressed against the chest to cause the heart to re-earn it.
Works by Peter Safar changed our perception of death as an one-stage phenomenon. “We used to think that death is instantaneous, and when we die, there is no turning back,” – says Sam guy from State University of New York at Stony Brook.
“Before, it was. But with the advent of CPR, we realized that the cells in our body do not die a few hours after we find ourselves in a state of clinical death. So even after you become a corpse, you can return to life “- explains Sam guy.
Death: the moment or process?
Tisherman considers death moment (obviously subjective) when doctors stopped CPR, seeing that it will not help. But, in his opinion, and then some people could be brought back to life.
In December, attracted the attention of many medical research article in the journal Resuscitation, claims that half of the respondents ambulance at least once witnessed the so-called “Lazarus phenomenon” (autoresustsitatsii) when the patient’s heart began to beat spontaneously after doctors have lost hope .
But the heart back to work – it’s just one of the challenges facing the Product Recovery. Lack of oxygen due to cardiac arrest can cause severe damage and major internal organs, especially the brain. “Every minute, when these bodies are not supplied oxygen, the process of dying,” – said Samuel Tisherman.
His former coach Peter Safar to solve this problem suggested the use of therapeutic hypothermia – cooling the body to about 33 ⁰ C. For this purpose, the body of the patient, for example, can impose ice. At a lower temperature slows cell damage, reduced their metabolism, and therefore – and ischemic tissue damage, which leads to lack of oxygen.
Application devices supporting artificial blood circulation and supplying it with oxygen, help extend the time between cardiac arrest and brain death.One of Texas clinics recently reported that 40-year-old man survived without any consequences for the brain after three and a half hours of CPR.
He did chest compressions, replacing each other doctors, nurses and even doctors, students, bystanders. “Everyone in the House who could help, asked to take part,” – says Dr. Scott Taylor Bassett.
However, such cases are rare. Bassett says that physicians continued resuscitation just because the patient during the procedure came to himself, despite the fact that his heart is still not working.
“During resuscitation he could talk to us, and we understand that neurological damage he had received, – says Dr. Bassett. – I’ve never seen anything – either before or after this event. Due to this we have decided to continue” .
Timing is everything
Such prolonged cardiopulmonary resuscitation is not currently possible for those with cardiac arrest due to severe gunshot wound or injury – for example, resulting in a car accident. Now for the surgeon in this situation the best option – to block the arteries leading to the lower part of the body, and then open the chest and massage the heart to supply a small amount of blood-brain until processed and sutured wounds. But, unfortunately, in such cases, it survives only one person in ten.
It is for this reason that Samuel Tisherman wants to cool the body 10-15 ⁰ C. This can give doctors more than two hours of surgery. Such cooling is sometimes used in heart surgery, but the technique Tishermana – this is the first example of recovery of the patient in a state of clinical death.
Perhaps the most surprising part of this procedure is that physicians should deflate all the blood from the patient and replace it with chilled saline. Since the body’s metabolism is stopped, it is not necessary to maintain blood cell activity, and saline solution – this is the most efficient way to cool the patient, says Tisherman.
Samuel Tisherman for two decades with Peter Rea and other colleagues collected database, confirming that this procedure is safe and effective.Proof of this are the numerous experiments on pigs injured, almost incompatible with life. In these operations, the doctors saw that the animals were already far beyond life and death, and, nevertheless, they managed to save.
“Patients with gunshot wounds were selected for the first test because in such cases it is easier to localize the site of bleeding “
“Pig whitened as much as possible, – says Peter Rea. – It turned into a pale refrigerated meat.”However, if the animals were cooled quickly enough – about 2 degrees Celsius per minute – almost 90% of them survived when the blood is pumped back into their body. Even after they have lain lifeless more hours. “For the present it was an amazing sight – to see how the animal’s heart begins to beat again,” – says Peter Rea.
After the guinea pig back to its normal state, the researchers conducted a series of tests to see whether their brain is damaged. For this procedure before they trained pigs open container of a certain color, which was hidden apple.
After his revival of most of the animals remembered where to look dainty.The other pigs, which were not taught before surgery, learned to do it soon after. They grasped the job as quickly as the others. This suggests that the procedure did not have any adverse effect on their memory.
It is clear that to obtain permission for the same experiment with people was very difficult. Earlier this year Tishermanu finally allowed to use the technique as test trials in patients who received bullet wounds in Pittsburgh.
“Many of us agree that, to preserve the brain is necessary to cool the body much more than is currently done. But go for it we do not dare “
An operation at the hospital this American city every month received one or two of these patients. This suggests that over the past few months some of them Tishermana technique has been tried. Although the results of this work, he does not want to share. Tisherman intends to conduct such tests in Baltimore, and if everything goes smoothly, Peter Rea will start the same work in the trauma center in Tucson, Arizona.
As with any other medical research, the transfer of these tests with animals to humans is associated with some difficulties. For example, at the end of the experiment the animals get their own blood, while people need blood donations, which spent a week in the store. Animals in the operation were under anesthesia, but people will have to do without it.
All of this can affect the body’s response. But Samuel Tisherman remains optimistic. “It is believed that the dogs and pigs react bleeding as well as humans”, – he says.
Doctors watching these experiments with great interest. “It’s very brave, – said Sam guy. – Many of us agree that it is necessary to preserve the brain cool the body much more than is currently done. But go for it we do not dare.”
If the tests are to plan, Tisherman intends to use his method to treat other types of injuries. Patients with gunshot wounds were selected for the first test because in such cases it is easier to localize the site of bleeding.
But he hopes that in the end will be the same and treat cases of internal bleeding – for example, as a result of the same accident. Perhaps someday this technique will be used to treat patients who survived a myocardial infarction and suffering from a variety of other diseases.
Success of the test may open the way to research and other forms of suspended animation. Some scientists want to test whether the set of medicines added to the salt solution further inhibit the metabolism and prevent damage to body tissues.
One of the most promising candidates for this role – hydrogen sulfide (hydrogen sulfide), a chemical compound that gives rotten eggs their unpleasant smell. As was found, it also reduces the metabolism of some animals. However, so far there is little evidence that hydrogen sulphide being toxic compound capable of increasing the chances of survival from cardiac arrest. Tisherman believes instead that it would be better to find powerful antioxidants capable of destroying chemical elements affecting cells.
Peter Rhee is convinced that the procedure “salt suspended animation” need to experience and implement as soon as possible. He told me about a patient who had seen the day before our conversation in the hospital.