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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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HA! Now give me some oxygen!
Mike @ The Geek Pub. Let's Make Stuff!
Parrots have recently been discovered to follow this exact same pattern during periods of deprivation from their beloved fjords.
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the number of things that we, as humans, seem to learn about ourselves each day and week. Theoretically, this could save thousands of people if they figure it out, and would possibly change how we look at the actual moment of death. Might this also be helpful in cryogenics? or how many other branches of medicine? Could this make organ transplants more safe? Could it make heart surgery safer?
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This has been long known by traditional chinese medical practitioners, who recognized that occidental materialist medicine was doing it wrong.
Still some pretty nice work and may lead to quite a few lives being saved.
A Shadeless room is a brighter room.
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.
Amazing. Given how many studies have shown that the US is backward technologically. How our medicine is falling further and further behind the socialized countries of Europe. How our school's aren't producing scientifically oriented graduates. It's unfathomable how this kind of thing could come from the shores of North America. Or possibly everyone with their reports of fucked US tech, meds, and science is just pushing an agenda.
It does not do any good to have a working body if I am still brain dead at the end of the process.
It might be useful so organs could be used for a transplant.
*pause*
Ahh, there it goes.
How we know is more important than what we know.
The secret to human DNA lies in 09-f9-11-02-9d-74-e3-5b-d8-41-56-c5-63
How do we wake the sleeper? I'd love for this to be part of that answer, in fact before someone went to sleep for the first time it would be ideal to know how to wake them.
The rock, the vulture, and the chain
Who knew... hypothermia to help cure your heart attack....
And it's finally a breakthrough that will help real problems.
Please, the penis pills are hardly lifesaving.
(But maybe marriage saving)
On a more serious note though, this is a pretty strange way for the body to work. Fascinating though to think about.
All men can fly, but sadly, only in one direction--Down.
It's not the fall off a tall building that kills you, so much as the sudden deceleration at the point you reach the sidewalk.
(Yeah, I know what the article's saying, but I couldn't resist.)
Now no more CPR for hot women!!!!!!
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.
We've known forever that post-ischemic reperfusion leads to free radical formation. Nothing new here, except for the suggestion that we change how patients are treated. Seems a little sensationalist to me.
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.
Balance deprivation does not kill you, it's the sudden restoration of terra firma that does.
Some drink at the fountain of knowledge. Others just gargle.
I forget the actual numbers, but the idea was really to simplify the procedure. It's more important to get blood flowing through the heart than do the breaths, so this way inexperienced people spend less time fumbling around with the breaths and more time pumping.
Tolerance does not tolerate intolerance, or hypocrisy.
Yeah, reprofusion injury http://en.wikipedia.org/wiki/Reperfusion_injury.
I wrote about that >20 years ago, when I was writing for a biotechnology newsletter. After >20 years of research, they understand it much better today.
Every surgeon knows about reprofusion injury. You can go to Barnes & Noble and look it up in a surgery textbook.
I don't understand why Newsweek says it's new or that it wasn't known in 1993. I assume those doctors came up with some new detail in its treatment.
anyone else get the world of warcraft ad above this story?
with the panel that reads "RESURRECT FOR FREE"?
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
Believe me, coming back from the dead is no problem-I've lived for hundreds of years! The secret? Solomonic gold!
(-1, Raw and Uncut is the only way to read)
http://www.answers.com/topic/umbrella-corporation
I am the unwilling control for my Origin.
I am a researcher in this area and this is really old news. Negovskii first proposed the concept of brain reperfusion injury in 1962 and it has been verified many times over. Both high and low levels of oxygen during resuscitation are bad for outcomes and that data is over 10 years old.
It's because Newsweek is a rag. As is Time. There is real, objective, intelligent journalism out there, but you're not going to find it in the supermarket.
Imagine if they would treat 13,256,278,887,989,457,651,018,865,901,401,704,640 people, damn that would be a lot!
Jokes aside, this guy & his team need some serious credit. Improving any method from 15% to 80% is impressive, but one that saves lives? That's just amazing. You, Sir, have my thanks & admiration.
This is not news. I learned all about reperfusion injury two years ago in my pathology class. Yes, IAAD (well, give it 17 days, but close enough)
So maybe the reprofusion stress is what causes that tingly pain that happens when you restore circulation to a leg or whatever that has fallen asleep and gotten numb.
This only works on the mostly dead. If someone's all dead, there's only one thing to do -- rifle through their pockets for loose change.
Seems like they could make use of some hydrogen sulfide as well:
1 B-035C-152C-835C83414B7F0000
u ced_hibernation
http://www.sciam.com/article.cfm?articleID=00089E
http://en.wikipedia.org/wiki/Hydrogen_sulfide#Ind
Just like "It's not the fall that kills you, it's the sudden stop at the end."
Or my favourite:
Q: "Did you hear?? Johnny fell 20 stories and LIVED!"
A: "Really? That's amazing!"
Q: "Yeah, unfortunately it was off a 21 story building..."
If I knew the wedgies I gave you back in 6th grade would have resulted in this . . . I might have taken a moments pause.
I believe that Wikipedia's entry on reperfusion injury is slightly wrong. This is what I wrote on its discussion page:
The general concept [of reperfusion injury] is that the actual damage from the ischemia to the brain does not actually occur until oxygen is reintroduced. Ischemia causes an influx of calcium into the ischemic tissue which activates a protease that converts xanthine dehydrogenase to xanthine oxidase. Both these enzymes eventually lead to the production of uric acid, the purine catabolic product. Hypoxanthine is the ultimate breakdown product of ATP metabolism (ATP to ADP to AMP to IMP to hypoxanthine). When oxygen is reintroduced (as after an ischemic condition such as a stroke), the xanthine oxidase goes to work on the large amounts of hypoxanthine that accumulated. (The dehydrogenase is what normally is used in vivo and does not produce reactive oxygen species.) Superoxide and hydrogen peroxide are formed in large amounts and cause the tissue damage. The clinical implications of reperfusion injury are addressed in Lancet 344:934-936 (1994).
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post yet...
Excuse me, but please get off my Pennisetum Clandestinum, eh!
From an article in Wired, scientists for DARPA are looking at how rapidly dropping oxygen levels could possibly be used to put someone in stasis until they can be moved to receive proper medical treatment. Apparently rats have been put into stasis and brought back already. http://www.wired.com/wired/archive/15.03/bemore.ht ml?pg=2&topic=bemore&topic_set=
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.
The article has a strange focus on the '5-minute window' of oxygen deprivation to heart muscle. Heart muscle can survive and recover far beyond that 5 minutes. Clot busting drugs can be give hours after a coronary artery becomes occluded, restoring blood supply to heart cells that have been without oxygen that whole time.
It's the brain that's exquisitely sensitive to oxygen deprivation. That 5-minute window refers to irreversible brain damage that begins to occur after ischemia, not heart damage. It's also well known that brain tissue releases toxic metabolites after oxygen deprivation doing damage above and beyond what the lack of oxygen itself did. There are a number of therapies aimed at reversing or blocking this phenomenon, but none have been successful yet.
The intervention that has been shown to be most effective in changing survival outcome once someone's heart has stopped beating is good quality CPR as soon as possible. Most of these other innovations like cooling have only a minimal effect changing a dismal outcome to a not-quite-as-dismal-but-still-pretty-dismal outcome. Most of these intra and post resuscitative interventions only succeed in allowing a patient to linger in the ICU for a few extra days before finally dying.
Could be, but AFAIK, it is more frequently the result of pinching the nerve.
Paresthesia.
Also, every time I've experienced this feeling, the prickling feeling starts after the pressure is relieved, which suggests that when the nerves start getting a signal again, they get a little confused, but that's just a guess.
Check out my sci-fi/humor trilogy at PatriotsBooks.
So recently it was discovered how to reactivate the mitochondria in cancer cells using DCA (Dichloroacetate)
And now someone has to create a chemical to do the exact opposite - temporarily.
So, we know that cancer deactivates the mitochondria, and DCA reactivates it.
Can we leverage cancer to save lives?
Would that not be the ultimate irony of all?
You're on the table, effectively dead.
The doctor gives you a massive dose of some cancer derivative and then starts CPR.
With this article, it seems believable that some day you won't bother with CPR at all. If cell death doesn't occur for hours, would there still be a benefit?
Wasn't April fools day a month ago today? :)
P
The thing about glucose is that when a solution of it and water is frosen ice crystals that harm the cells do not form easily. Basically the aim of this cryo-stuff is to render and entire body into a glass-like state, and most things can be put in such a state by freezing them really, really fast. For pure water, the speed-of-freezing required is quite astronomical, but luckily water doesn't have to be pure.
The technical term for converting a substance into a glass-like material is vitrification. Wikipedia knows more:
http://en.wikipedia.org/wiki/Vitrification
All rites reversed 2010
show off that your married to a vet and probably a kept man...you bastard!
The Kruger Dunning explains most post on
I read that as "More congressmen = less oxygen."
I freedive recreationally, a sport that involves extended periods of breath-holding. (I've trained myself to hold my breath for over five minutes.) It would be interesting to know to what extent these reperfusion effects apply to intentional periods of oxygen-deprivation without losing consciousness.
Weeks of coding saves hours of planning.
There is an excellent, if little known SF novel about this: "Recalled to Life" by Robert Silverberg. The only "SF" element is a medical procedure for resuscitating people dead for up to about an hour (assuming the cause of death didn't preclude this - i.e. good for heart attack and drowning victoms, but not useful against cancer.) The book is about the social, religious and political backlash.
Quattuor res in hoc mundo sanctae sunt: libri, liberi, libertas et liberalitas.
About 20 years ago, I worked for a while in a nephrology lab. They had observed that kidney failure after an interuption of the blood supply occurred as oxygen was reintroduced. They found that bathing the kidney cells in glycine offered significant protection from damage caused by oxygen.
Well, it just so happens that your friend here is only mostly dead. There's a big difference between mostly dead and all dead.
According to this article, treated properly, treated differently, with new and evolving protocols we have an hour more to save your life now!
The implication is that we were wrong about way hyperthermia can save people who've drowned. It isn't that the cells slowed and didn't use oxygen, it's that the cold can prevent the self-destruct when the oxygen comes back. So, it didn't matter that the patient was cold the whole time, it only mattered if he were still cold at the moment he were put on oxygen!
There was already a first study. It works, cool patients a lot, even inject a slurry of partially frozen saline and infuse oxygen slowly, putting them on heart lung machines instead of restarting the heart quickly and 5 times as many of them live.
Amazing.
It looks like heart attack and drowning deaths are about to go WAY down in countries where we can afford this sort of care because suddenly we have an hour to save you, not five minutes.
Unfortunately, I hear the surviving test patients all had strange cravings for "brains" after reviving. George Romero was called in to consult...
It must have been something you assimilated. . . .
You're not going into deep desaturation this way - your heart is still beating and there's more than enough oxygen in the air in your lungs to last you for a couple of minutes (I assume that your training also led to a lung volume that's way above average).
IANAMD,but they teach you in elementary school that sells can survive many hours, this is how organ transplants (and some trauma treatments) possible. Except for the brain cells, which are begin to die after about five minutes. So, after an hour this guy look at the HEART cells, and they alive. No shit. "We thought we'd done something wrong". Yes, you are. Try reproduce the results with BRAIN cells, THAN jump to whatewer conclusions, and post articles. IF it works.
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?
...and the most famous company in the field is Alcor.
I read their FAQ on ischema and reperfusion injury some time ago.
Let's ban it, right along with dihydrogenmonoxide.
I'm skeptical that you've dismissed this article so easily. Ok, so people have known that reprofusion can cause injury for 20+ years? But the article says more than that. It says -
Reprofusion not only causes damage, it is the primary or only source of cell damage for short term oxygen loss (less than an hour).
Reprofusion damage can be limited in several ways, and recently some of these have been tested in the field very successfully.
Now is all of that "really old news" as you state?
So basically you are saying that people will choose a more unhealthy lifestyle and that the spending per capita goes up if healthcare is free? So name me any country where this has happened? And if the reverse can be found in overwhelming numbers, will you admit your whole theory is just a fantasy based on party ideology instead of reality?
In that case, I urge you too look at any country in Europe that has this socialized healthcare you detest so much. Europeans are much more healthy and spend an order of magnitude less on healthcare than USians.
Now it is time to stick your head in the sand again...
This space is intentionally staring blankly at you
Unless your head spontaneously combusts, there's still a chance for you to get up and walk it off for about as long as your organs are viable.
I'll still grasp at that chance, even if it costs some random stranger a better one.
Also, every time I've experienced this feeling, the prickling feeling starts after the pressure is relieved, which suggests that when the nerves start getting a signal again, they get a little confused, but that's just a guess.
Not exactly confused. Compare this to being for a while in a very dark room, your eyes adjusting to the low light levels, and then walking out into the summer sun. In either case, the nerves have been trying to adjust to a very weak signal, and suddenly the signal is blasting in at high power. Instant information overload.
Article claims that cell "die" not when they are deprived of oxygen (because "we couldn't see evidence the cells had died"), but after the oxygen supply is renewed.
Does the cell die in a state when oxygen supply does not go away because of oxygen? Obviously not. Oxygen molecules are coming, cell does not die. What happens after oxygen deprivation:
(a) oxygen is coming in the same way, but cells react differently to it. Obviously, the cells were NOT the same. They changed BECAUSE of the LACK of oxygen. Given that applying term death to anything other than an integral organism is questionable anyway, this observation nails further the futility of ascribing "death" to individual cells. I would say in this case "cells sustained irreversible damage". Or
(b) cells are indeed intact (hard to believe since oxygen is essential for many processes in the cell, so I am adding this point only for the sake of argument), but there are some changes in the way oxygen is supplied to the cell, which is not acceptable.
I do not believe in karma. "Funny"=-6. Do good and forbid evil. Yours, Oft-Offtopic Flamebaiting Troll.
One can't help but wonder how this relates to the recent discussion about how chest compression is more important than ventilation while performing CPR (to the point where you should probably just focus solely upon the compression). If the cells have started to become vulnerable, and sudden resumption of oxygen might be damaging, then perhaps these findings are indeed related. (Compressions alone probably jiggle some air into the lungs, and a more gradual resumption of oxygen might be better.)
Or are we talking totally different timeframes of oxygen starvation here?
Love many, trust a few, do harm to none.
"This is faster than you think and believe it or not is incredibly difficult to do. For the tempo, think "Another One Bites the Dust"
Must not be that hard for musicians then, especially us drummers. 240 BPM chest compressions, no problem!! Lemme just put both of my feet on 'em, I'll play 'em like a kick drum with dual pedals!
Still waiting on Serviscope_minor to wake up to fucking reality and realize that Jessica Price isn't going to fuck him.
...but the fire service union is just too strong.
it's best to take smaller, slower breaths when you're too drunk to move.
sometimes, nothing.
Every surgeon knows about reprofusion injury. You can go to Barnes & Noble and look it up in a surgery textbook.
I don't know what's scarier: that surgeons might buy surgery textbooks at Barnes & Noble, or that people who AREN'T surgeons might buy surgery textbooks at Barnes & Noble.
Actually this may mean you can save a lot more people, not just heart attack and drowning ones. And could change what it means to "stabilize" a person in an emergency.
;).
A single motorcycle can carry a lot of "hypothermia" inducing stuff. You send one or two bikers to the scene instead of one ambulance - bikes can get through gridlock a lot faster[1].
They get there ASAP, put the victim on "pause", and then they have a lot more time to bring them back to the hospital, where the ER team can fix them based on the new knowledge.
You might be able to quickly convert an "ambulance" bike to a tricycle to carry the patient back (while "paused").
[1] Of course one must take measures to significantly reduce the odds of the bikers becoming accident victims themselves
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).
Hoooneeey! Dinner is served!
It is
--- I am known for the ones who want to find me on the net. Is that a privacy risk or a privilege? One might wonder..
On a long enough timeline, the survival rate for everyone drops to zero.
-The Narrator
Reality has a conservative bias: it conserves mass, energy, momentum...
Of course, if you died in a traffick accident or something, the chances are that your brains are splattered on the sidewalk. I'd say that it's a bit unlikely that you'll walk from that, even if the cells aren't dead :).
Forget magic. Any technology distinguishable from divine power is insufficiently advanced.
This would explain why taking aspirin after a heart attack can prevent heart damage.
-Darkshadow (There was a thing called Heaven; but all the same they used to drink enormous quantities of alcohol.)
Of course, if you died in a traffick accident or something, the chances are that your brains are splattered on the sidewalk. I'd say that it's a bit unlikely that you'll walk from that, even if the cells aren't dead :).
On the assumption that you're serious, um, no. Grey matter is very rarely encountered in emergency medicine - maybe 1% of the trauma calls I've been on, max. Sure, once the egg is cracked, you're not getting 'em back, period, but that doesn't happen all that often, even in motorcycle vs. car crashes.
That said, in trauma cases, they reason they're dead isn't chemical, it's mechanical. They're dead because their spinal cord is snapped too high to survive. Or they're dead because of massive blood loss, internally or externally. Or they're dead because large chunks of them aren't where they should be. etc etc etc. Fixing the biochemical balance is one thing, fixing the mechanical problem that caused them to be dead in the first place is entirely different. I can see this being helpful in cardiac events, for instance, but for things like traumatic injury, not so much.
What a fascinating machine we are.
About the U1MR (under 1 mortality rate) and the U5MR (under 5 mortality rate) can be found here:
http://www.unicef.org/sowc04/files/Table1.pdf