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Day 8: Treating the dead

May 1, 2007

I came upon this article in Newsweek…I’m floored-

heart.jpg

“As recently as 1993, when Dr. Sherwin Nuland wrote the best seller “How We Die,” the conventional answer was that it was his cells that had died. The patient couldn’t be revived because the tissues of his brain and heart had suffered irreversible damage from lack of oxygen. This process was understood to begin after just four or five minutes. If the patient doesn’t receive cardiopulmonary resuscitation within that time, and if his heart can’t be restarted soon thereafter, he is unlikely to recover. That dogma went unquestioned until researchers actually looked at oxygen-starved heart cells under a microscope. What they saw amazed them, according to Dr. Lance Becker, an authority on emergency medicine at the University of Pennsylvania. “After one hour,” he says, “we couldn’t see evidence the cells had died. We thought we’d done something wrong.” In fact, cells cut off from their blood supply died only hours later.

But if the cells are still alive, why can’t doctors revive someone who has been dead for an hour? Because once the cells have been without oxygen for more than five minutes, they die when their oxygen supply is resumed

Researchers are still working out how best to do this. A study at four hospitals, published last year by the University of California, showed a remarkable rate of success in treating sudden cardiac arrest with an approach that involved, among other things, a “cardioplegic” blood infusion to keep the heart in a state of suspended animation. Patients were put on a heart-lung bypass machine to maintain circulation to the brain until the heart could be safely restarted. The study involved just 34 patients, but 80 percent of them were discharged from the hospital alive. In one study of traditional methods, the figure was about 15 percent.”

Full article here

I mean, I knew about reperfusion injury but…wow, this is cool.

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3 Comments leave one →
  1. May 4, 2007 11:43 am

    Whoa. The problem is not that you can’t restart the heart, it’s what happens before you restart it. If you’re in pulsless arrest for four, five, six, ten minutes (or longer) as sometimes happens maybe we don’t want to bring you back as there will be very little left of the cognitive you, even if your heart is ticking away happy as a clam.

  2. May 4, 2007 2:05 pm

    Ya really. Does their theory apply to all cells, as in… is brain damage a reperfusion injury? They say that 80% of people were discharged. They don’t say in what condition they left.

  3. May 8, 2007 12:49 pm

    Hey,

    Nice blog..
    Interesting article..
    Though I d like to what happened to the patients who were ‘revived’..

    Best Regards,
    Anuja.

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