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Treating the Dead
FlyByPC writes "According to a NewsWeek article, oxygen deprivation doesn't kill patients as much as the resumption of oxygen does. This discovery could bring about new ways of resuscitating people whose hearts have stopped."
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I remember reading somewhere in the last few months (possibly here on /.) that the new preferred version of CPR was 10 compressions to one breath, as opposed to the traditional 3. More compressions = less oxygen. . .
My sister opened a computer store in Hawaii. She sells C shells by the seashore.
While I agree that traditional Chinese medicine has disagreed with western treatments, I'd be very interested in seeing any kind of supporting documentation that this specific bit of knowledge has been know to Chinese practitioners for any length of time that would be considered long.
This reminds me of Freezing Frogs. Basically they fill their cells with glucose, and are actually able to freeze themselves for the entire winter and then wake up in the spring. I remember a radio show where they were saying you could freeze them over and over again, without any adverse effects.
Anthropic principle: We see the universe the way it is because if it were different we would not be here to see it.
cells use what energy is available to them, they also have backup systems of sorts that prevent non-essential reactions from killing the cell [metabolic feedback] too much or too little of a substrate affects reactions like this: suppose a brain cell runs low on ATP [energy currancy] it shuts down anything but what it needs to live, in this case fewer electrical impulses which also means brain shutdown as a whole. shutting down brain function is preferrable to "death" from a cell's point of view. These cells don't just die instantaneously, they live on and switch to using anaerobic pathways that make energy without air, these can be distrupted by addition to oxygen, in fact cell processes grind to a halt when metabolic processes need to change. during that time RNA is transcribed for the needed enzymes and protein synthesis takes precedant. In this case, cooling the body down to lower oxygen requirements and introducing oxygen slowly might allow the cells to revert to near-normal function. In the past a patient was known to have been submerged underwater without air in very cold temperatures and have their heart/brain revived after 4 hours.
Sigs are too short to say anything truly profound so read the above post instead.
It even makes sense to me why sudden resumption of oxygen should be lethal. Oxygen is extremely toxic and aerobic organism, such as ourselves, had to evolve complex cellular machinery in order to utilize it for metabolic efficiency, while keeping the oxygen from damaging cellular structures, especially DNA. The sudden surge in oxygenated blood would probably overload this system. Apoptosis in this case may be a protective step by killing the cell before its DNA becomes damaged and possibly cancerous. Thus, flooding the heart with oxygen causes the whole heart to "take one for the team," and shut down completely.
The discovery that the cells are still alive, and can be revived with special treatment is extremely encouraging for the development of better techniques.
Other arguments against socialized medicine include: years-long queues for certain sorts of procedures (which aren't strictly Necessary, but may be Incredibly Useful), the sheer cost of paying for it, and a tricky sort of little moral hazard problem with implications against freedom. (Specifically, if the government has to pay for your health care, then a - you're probably less likely to try and take preventative measures to maintain your health since the Government will deal with it and you won't have to pay for it as heavily as you would otherwise; this contributes to a larger problem: b- being unhealthy means more money out of the federal budget, so the government has a big incentive to make unhealthy activity illegals, and the next thing you know, they could be forcing tofu cubes down your throat screaming "it's good for you!!!!!" when all you want is a hamburger, a simple hamburger, for the love of all that is holy - well, figuratively speaking, anyway; you get the idea.)
The unarguable fact that's in support of socialized medicine is "it will make certain peoples' lives better". It will also probably make people's lives worse - rich people, healthy people who pay taxes, and Future people. For typical middle-class people, it's less than clear.
The World Wide Web is dying. Soon, we shall have only the Internet.
I mentioned this to my wife as I started reading it (who was massaging a heart earlier today, trying to resuscitate the animal) and her response was that "reperfusion injury" was well known. Then I read that word in the article. Then she described it to me.
She also explained that when the cells stop getting oxygen, they start going into anaerobic respiration, and the other issue is all the toxins that get released into the circulatory system once the heart starts pumping again.
Anyway, yeah - when a body dies, almost all the cells in the body are certainly still alive. That's not the point though - the cells have to be happy, then the tissues, then the organs, then the body as a whole. Once the body stops working as a whole, it doesn't matter that almost all the cellular components are, on a cellular level, still alive.
Says she, resuscitations in animals are even far less frequent than the 15% listed in the article for humans. And in the ones that do survive, they almost always have "reperfusion injury."
Basically there's another theory that says that, while cells start to die at low oxygen levels, if you reduce the amount of oxygen really really low then they'll stop metabolizing and killing themselves. Apparently either cryo or certain toxins will reduce oxygen intake to a level where the test subjects- animals of course- could survive in a not-alive (but not dead) state for hours.
You were aware of it more than 20 years ago and wrote for a biotech newsletter? So... why do you still have trouble spelling it?
I've put a similar principle in practice with yeast cultures (I am a homebrewer). I don't recall the exact ratio off the top of my head, but if you replace some of the water in a yeast slurry with glycerin, you can safely freeze yeast cultures for a long time. This is very useful to me, since certain beers are seasonal (like Belgian Wit), and in order to maintain the yeast's viability, I would otherwise have to brew this beer regularly, or buy the yeast from a store, which can get expensive (~$7 a vial). The glycerin prevents the yeast's cell walls from bursting due to the crystallization of the freezing water. I am not a chemist, so I have no idea how this actually works, I just know it does.
Unfortunately, my girlfriend doesn't share my enthusiasm for frozen fungus, so our freezer has more room devoted to more mundane things, like frozen vegetables and animals.
For what it's worth, you can do the same with most insects. When I was a twisted, biologically-inclined child, I froze/thawed grasshoppers, sometimes upwards of 20x in a row, and they were still viable. A bit stupid and not jumping right, but still moving and eating. Weirdly, it was my experience that they did better if they were thawed slowly (more than 30 minutes) than quickly, while many other people doing cryrogenics use flash-freezing. I suspect very slow freezing allows the insect to produce materials like glycols that prevent long, damaging ice crystals from forming, while fairly quick freezing does make long ice crystals, and flash-freezing is too quick for long ice crystals to form.
Many fish can also freeze solid and survive. I've read about people chipping thousands-of-years-old fish and frogs out of polar ice and reviving them.
Nostalgia's not what it used to be.
Potentially, the greatest benefit of this research could be in cases where a patent comes in to the ER with the heart still beating, but too seriously injured to save with current knowledge.
At that point, doctors could potentially pre-treat the patient to inhibit the damage from reperfusion, get the heart-lung machine in place and essentially manage the process of cardiac arrest. They then have considerably more time to repair the damage surgically and treat blood chemistry problems. Once ready, they could then manage the reperfusion process carefully.
Eventually, another leap in survivability could come about once equipment becomes available to allow paramedics to handle managed arrest in the field.
Still later, as the technique is refined further it will no longer be such a last resort technique. It may open the door to surgical procedures that are simply out of the question today.
Assuming any of this works out, there will be a LOT of legal and ethical fallout. While the new techniques will likely result in saving a lot of lives where the patient goes on to substantially recover, it may also result in a number of cases where the patient lives but doesn't really recover. The latter happens now as well, but thus far society mostly just pretends it doesn't happen and ignores those stuck with the consequences (except when congress calls an emergency session attempting to make sure someone remains stuck with the consequences). It's infrequent enough now that we (as a society) more or less get away with ignoring it.
Ultimately it may force us to think legally and ethically about the difference between "not dead" and "alive" (and perhaps better terminology for the difference).
That is perfectly true, in theory. In practice, Britain's medical system certainly performs a lot of experimental medicine - usually "unofficially" (patient consents, but there's no paperwork), most frequently for conditions deemed highly life-threatening or otherwise terminal, but sometimes for less-serious but "untreatable" conditions. These are usually not "controlled" experiments, participation is usually large and pre-existing evidence is usually marginal.
(And, yes, quite a bit of this is first-hand knowledge, the rest is from direct interviews with those carrying out the medical experiments.)
Indeed, a recent BBC report suggested that as much as 75% of treatments recommended by GPs in Britain had no scientific basis whatsoever. Obviously, I can't verify that one, but it agrees with my own experience well.
I don't know as much about the American health system, but there are documented reports of doctors injecting foetal cells into alzheimer patient brains (ten-to-fifteen years ago), or experimenting with non-FDA-approved medicines (not always with consent), which makes me think it's not just that side of the Atlantic.
However, these therapies almost always have something in common - they'd be damn-near impossible to sue over, for a whole range of reasons - the main one being that it's easy to be discrete with them. Slow-revival techniques would involve a lot more people, probably including friends/relatives. Dodgy pills are much easier to keep under the radar.
I'm not saying this is right - it's often highly unethical - and yes, evidential methods are definitely the way medicine should be practised. The evidence would seem to suggest, however, that it's only practised when the doctor is as much at risk as the patient.
It's a small world and it smells funny; I'd buy another if it wasn't for the money; Take back what I paid (SoM)