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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."

31 of 246 comments (clear)

  1. In other news... by Dragon+By+Proxy · · Score: 5, Funny

    Parrots have recently been discovered to follow this exact same pattern during periods of deprivation from their beloved fjords.

    1. Re:In other news... by martinX · · Score: 3, Funny
      --
      When they came for the communists, I said "He's next door. Take him away. Goddam commies."
    2. Re:In other news... by skoaldipper · · Score: 3, Funny

      we should aim to reduce oxygen uptake, slow metabolism and adjust the blood chemistry for gradual and safe reperfusion.
      So, a slow Rip Van Winkle type recovery process instead?

      God forbid, and hypothetically speaking, a heart attack victim from an ambulance ride to finally waking in a hospital recovery room days later could go from this to this?
      --
      I hope, when they die, cartoon characters have to answer for their sins.
  2. I'm continually amazed at by zappepcs · · Score: 3, Insightful

    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?

    1. Re:I'm continually amazed at by CastrTroy · · Score: 4, Interesting

      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.
    2. Re:I'm continually amazed at by zCyl · · Score: 4, Funny

      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?

      Don't hold your breath...

      And if you do, don't stop.
    3. Re:I'm continually amazed at by Kenshin · · Score: 5, Funny

      I remember a radio show where they were saying you could freeze them over and over again, without any adverse effects.

      I'm certain they would be fairly pissed-off.

      --

      Does it make you happy you're so strange?

    4. Re:I'm continually amazed at by WindBourne · · Score: 5, Funny

      Do it slowly enough and they never notice. It was when I tried to microwave one that it got really pissed and blew up on me.

      --
      I prefer the "u" in honour as it seems to be missing these days.
    5. Re:I'm continually amazed at by raddan · · Score: 3, Interesting

      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.

  3. Makes a little bit of sense. . . by MagusSlurpy · · Score: 5, Interesting

    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.
    1. Re:Makes a little bit of sense. . . by dbIII · · Score: 3, Interesting
      No - just more blood flow. I heard this from a doctor many years ago when I asked about the number of compressions - what they were taught was to keep things going as fast as you can mangage for as long as you can and just a few breaths. It's just made it into all of the first aid courses recently after working out how long people can keep it going. I beleive people have survived after requiring CPR for many hours (jellyfish sting) so it has to be something two people can keep up indefinately but fast enough to work.

      A few years ago I recall hearing something about people drowning in very cold water and care having to be taken to restore oxygen slowly (Australian ABC Radio Heath Report - Dr Norman Swan), but I don't know what the primary source for that information was.

    2. Re:Makes a little bit of sense. . . by necro81 · · Score: 5, Informative

      I'm not sure if the guidelines vary by country, but the U.S. guideline was 15 compressions for every 2 breaths (5 + 1 if two people are working). The guidelines were changed to 30 + 2 at the end of 2005. The reason for the change, as others have mentioned, is that the circulation of blood is most important. Rescue breathing takes time, is harder to do correctly than chest compressions, and takes time (consider it an operational overhead). Also, the compression of the chest causes some air movement on its own, though it is shallow.

    3. Re:Makes a little bit of sense. . . by EaglemanBSA · · Score: 3, Interesting

      Actually, it's more oxygen. The idea is that the alveoli can absorb enough oxygen from one breath to last for more compressions than was previously though. Up until about two years ago the accepted practice was 15 compressions/2 breaths, now it's 30 much harder, faster compressions/2 breaths. The idea behind it is to get more blood to flow to the brain and provide more oxygen.

      And in case you've never had to do it, one round of CPR at an actual pace will exhaust you if you do it right. The new methodology is pretty intense.

      --
      Quiz: True or False -- On a scale of 1 to 10, what is your middle name?
    4. Re:Makes a little bit of sense. . . by sharky611aol.com · · Score: 5, Informative
      Wow, way too much pseduoinformation here. I'm ACLS certified, so take this to the bank:

      First off, a public service announcement. The current guidelines (which are actually backed up by some pretty good science) are a ratio of 30:2 compressions to breaths. Another important thing to note is that the rate of compressions is 100/min. 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" (and pardon my irony).

      Ok, now on to the reasoning behind the change. ("Well, I could explain it better, but I'd need charts, and graphs, and an easel.") Essentially, the flow of blood through the arteries and into the myocardium requires the creation and maintenance of a pressure head. Research has shown that it takes about 5-7 compressions to create that pressure head, and every time you stop pumping, you lose that pressure. Now only when this pressure head exists is oxygen being delivered to the myocardium, thus any time you stop pumping, you're creating a period of time in which oxygen is not being delivered. And apparently 30:2 was the best ratio for oxygenating blood in the lungs and delivering blood to the heart.

      Here's the official guidelines and all the studies behind them in all their linky goodness. http://circ.ahajournals.org/content/vol112/24_supp l/

    5. Re:Makes a little bit of sense. . . by NIckGorton · · Score: 4, Insightful

      Actually the primary reasoning for the change was largely to keep it simple. This means there is ONE ratio to remember for all lay-rescuer (single person) CPR for anyone that is not an infant.

      There is not a single 'ideal' compression to ventilation ratio. We know that for garden variety cardiac arrest due to V-Fib, ventilation in the first minute or so is probably almost meaningless. We also know that for hypoxic arrests (like a drowning) that ventilation is far more important. We also know that VFib makes up a greater percent of adult arrests and hypoxic arrests are more common in kids (all of whom get the same ratio.) Moreover the AHA made this decision knowing that they didn't even know the ideal ratio for the single most common type of arrest in the community (from VFib.) The 30:2 ratio was a way of keeping it simple that is not perfect for every kind of arrest, but is a reasonable compromise to try to deliver at least a reasonably acceptable type of CPR to all victims of arrest.

      That is a good thing for lay-rescuers, but the AHA understands that people who are more highly trained and knowledgeable will guide their actions based on that knowledge. For example, if my partner grabbed his chest and collapsed, I would run to the phone, call 911. Return to him, check for a pulse, and if he had none, start wailing on his chest like a crazed weasel on crack. I would not even consider breaking compressions to give a breath till at least minutes had passed - or more trained people arrived and ACLS could be initiated. If however, I pulled him out of a pool, I would check for breathing and if none, give two full rescue breaths. Then check for a pulse, if none, start CPR with probably about a 15-20:2 ratio. I would stop for a moment at 1 minute. If he had a pulse, I would continue breathing for him a full minute or two before I ran to the phone. If he had no pulse, I would give two last breaths and run for the phone.

      Those are drastically different methods that I chose knowing that they would give him the best chance in either situation. But if you try to teach lay-rescuers that, you will get blank stares and some shitty-assed CPR. So it is better to make things as simple as possible and make them so at least everyone gets 'reasonable' CPR.

      Nick

  4. What about the brain though. by mpn14tech · · Score: 3, Insightful

    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.

    1. Re:What about the brain though. by tomhudson · · Score: 5, Funny

      "It does not do any good to have a working body if I am still brain dead at the end of the process."

      Why not? George Bush choked to death on a pretzel a few years ago, and nobody's noticed the difference ...

  5. Re:Traditional Chinese Medicine Recognizes This by Score+Whore · · Score: 3, Interesting

    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.

  6. Re:Not completely new by tomhudson · · Score: 4, Funny

    "I recall reading an article in Science News late 70's or early 80's about some research showing it was the blood vessels in the brain spasming that lead to brain death."

    ... that's a hang-over. You just WISH you were dead ...

  7. Re:FP!!!! by Short+Circuit · · Score: 5, Funny

    Now give me some oxygen! For a post like that? Don't hold your breath...
  8. This makes sense in a lot of ways. by Cadallin · · Score: 5, Interesting
    Trying to chill the body of someone in Cardiac arrest, for example, makes perfect sense. People survive hypothermia, even with after they stop breathing and their heart stops beating, remarkably well. I've read about Russians having used this technique during open heart surgery. They lacked machinery like cardiac pumps, so they cooled the patients down and stopped the heart and breathing, while doing the surgery on a bed of ice. It apparently worked far, far better than our technophile medicine in the USA would lead us to believe.

    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.

  9. Falling does not kill you by goombah99 · · Score: 4, Funny

    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.
    1. Re:Falling does not kill you by hobo+sapiens · · Score: 4, Funny

      It was a grave mistake to make such a stiff joke. I cadaver get excited about jokes like that. Oh well, we have to commend you for the undertaking.

      Hot cha cha cha cha!

      --
      blah blah blah
  10. Make it simpler.... by zoltamatron · · Score: 4, Informative

    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.
    1. Re:Make it simpler.... by hackerdownunder · · Score: 4, Funny

      I forget the actual numbers 09 F9 11 02 9D 74 E3 5B D8 41 56 C5 63 56 88 C0
      There you go.
  11. Old news -- reprofusion injury (really old news) by nbauman · · Score: 4, Insightful

    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.

  12. whoa by circletimessquare · · Score: 4, Funny

    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
  13. Re:This was discovered in the US? by Nutria · · Score: 5, Insightful
    Huang, Ahmad, Silvfast, Skifvars, Vanden Hoek, Khan - all good American names :)

    Yes, actually, they are good American names.

    --
    "I don't know, therefore Aliens" Wafflebox1
  14. Re:This was discovered in the US? by FooAtWFU · · Score: 4, Interesting
    This is one of the big arguments against socialized medicine: since you can make $$$ off medicine, lots of people go into medicine to make $$$ and come up with new and interesting stuff. And this cannot be entirely replaced by government funding. And after the companies have made their billions off the drugs, the patents expire, and after a few decades you've got trillions of dollars worth of medical knowledge that you wouldn't have been able to get otherwise. The cost of this? The poor cannot afford the good medicine.

    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.
  15. Doesn't work on the dead by Grapes4Buddha · · Score: 3, Funny

    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.

  16. It's the brain we worry about, not the heart by neoshmengi · · Score: 3, Insightful

    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.