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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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Parrots have recently been discovered to follow this exact same pattern during periods of deprivation from their beloved fjords.
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.
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.
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.)
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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.
Grammatically-oriented graduates, either...
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
http://www.answers.com/topic/umbrella-corporation
I am the unwilling control for my Origin.
Yes, actually, they are good American names.
"I don't know, therefore Aliens" Wafflebox1
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.
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.
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).
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.
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. . . .
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
IANAMD,but they teach you in elementary school that sells can survive many hours
Thank Christ. I'd be worried if an MD couldn't spell "cells".
"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.
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).