My Thoughts on Technology and Jamaica: How UPMC Presbyterian Hospital and EPR-CAT Trials enable Suspended Animation Space Travel

Monday, August 25, 2014

How UPMC Presbyterian Hospital and EPR-CAT Trials enable Suspended Animation Space Travel

“When you stop the machinery of life, that's not when death starts. If you were dead for a day I would not be able to bring you back. But we're talking about 5 to 15 minutes. If you're cooled straight down, you have a chance.”

 Dr. Peter Rhee, a professor of surgery and chief of trauma, critical care, burns and emergency surgery at the University of Arizona commenting on the emergency preservation and resuscitation Trials at the UPMC Presbyterian Hospital in Pittsburgh, Pennsylvania

Journeys to the far outer reaches of the Galaxy may soon be possible.

This thanks to an ongoing experiment into Suspended Animation that started in May 2014 as reported in “Suspended-animation trials to begin on humans”, published May 25, 2014 9:24 PM PDT by Michelle Starr, CNET News and “World’s first human trial of ‘suspended animation’ to get underway”, published MAY 27, 2014 2:50PM by Network Writer, News Corps Australia Network.

The Researchers involved in this unique and very historic study at the UPMC (University of Pittsburgh Medical Center) Presbyterian Hospital in Pittsburgh, Pennsylvania are Lead Surgeon Dr Samuel Tisherman and Dr Patrick Kochanek, which began in the month of May 2014 looking for 10 suitable patients upon which to conduct their experiments.

In fact, it might explain the shortage of Saline Jamaica experienced a month later in June 2014 as most likely every hospital began experimenting with this technique “IV Fluid Crisis - 'People Are Going To Die' As Hospitals Face Shortage”, Published Tuesday June 10, 2014, by Edmond Campbell, Senoir Staff Reporter, The Jamaica Gleaner.

That issue was later resolved by Monday June 16th 2014 when Food for the Poor donated 16,000 units IV Fluids, specifically Normal Saline, Dextrose and Lactated Ringers as stated in “Food for the Poor to donate IV fluids to Heath Ministry”, published Sunday, June 15, 2014 10:09 AM,  The Jamaica Observer and “'Fluid for the Poor'”, published Monday, June 16, 2014, The Jamaica Observer.

Two weeks later by Monday June 30th 2014, the NHF was able to procure 120,000 units of IV Fluids, among those units of course being normal Saline as noted in by the Horse’s mouth in the article “Shipment of IV Fluid To Arrive This Week”, published June 30, 2014 By Marlon Tingling, The Jamaica Information Service.

Interestingly too, the doctors involved in this Study disguised as a trial aren't too happy about bloggers making these references to their medical procedure to quote Dr Samuel Tisherman, the surgeon who will lead the trial: “We are suspending life, but we don't like to call it suspended animation because it sounds like science fiction. So we call it emergency preservation and resuscitation”.

Technically speaking it isn't the same as Sigourney Weaver going into Suspended Animation from the movie Aliens. Rather, this trial it’s the start of an Emergency Trail for a technique called EPR-CAT (Emergency Preservation and Resuscitation for Cardiac Arrest From Trauma) or EPR (Emergency Preservation and Resuscitation) for short.

EPR-CAT is based on 20 years of Research conducted by Dr. Peter Rhee, a professor of surgery and chief of trauma, critical care, burns and emergency surgery at the University of Arizona and the research is supported by the Department of Defense.

But aside from its obvious significance to improving the Survival of persons suffering from Severe Trauma and surgical operations where the patient’s survival decreases with the loss of Blood, the Sci-Fi option is obvious. This as EPR-CAT may mark the beginning of research into Suspended Animation for the purpose of travelling to Distant Stars and exoplanets in the Milky Way Galaxy, the main reason why this article caught my eye.

Emergency Preservation and Resuscitation – Years of Anecdotal Observations of Supercool Blood

Also, in most ER (Emergency Rooms) around the world, especially if they have water and ice on hand, Doctors may choose to lower body temperature using ice packs and even passing Blood through an external Heat Exchanger. This technique is very similar to Dr. Rhee's idea, except it requires proper planning and must be done within the first 7 minutes of cardiac arrest i.e. the patient’s Heart stopping.

This technique, if organized and done right, would reduce Blood flow and this allow surgeons to perform life saving surgery such as removing shrapnel or sewing up damaged Blood vessels and arteries. Please note that the use of Ice packs or a Heat Exchanger to cool down the Blood isn't an immediate option, especially if the person's Heart has stopped beating due to a gunshot or knife stab wound. 

If the Heart has stopped beating due to extreme Blood loss, the Doctors have mere minutes to stop bleeding and restart the Heart. With that level of Blood loss, a Blood transfusion is necessary with matching Blood. This may be difficult to source, especially if the persons has the very rare Type O Negative (–), which albeit being the Universal Donor, can only take Blood from another persons with Type O Negative (–).
Using synthetic Blood isn't an option as yet, despite the progress of the Scottish National Blood Transfusion Service  in making artificial Type O Negative (–) Blood as described in my blog article entitled “Scottish National Blood Transfusion Service develops artificial Type O Negative Blood - Stem Cell Cloning of Type O Negative Blood for Cheaper Transfusions in 2016”. Plus the act of resuscitation exposes the body to oxygen, to which body can react by releasing chemicals that may result in death from Blood infusion injuries and wounds that may have become septic.

Dr. Peter Rhee and Suspended Animation – One small Step for Pig-kind back in 2000

He's been playing God for quite awhile, mainly with Pigs back in 2000. Please note Pigs and not the Guinea kind, as their Hearts are too small.

His research was prompted mainly by reports from Medics in Vietnam who noticed that patients likelihood of survival decreased with the amount of Blood in the first 5 to 20 minutes after a severe injury i.e. grenade explosion or being hit with a large round that cause massive loss of Blood as stated in the article “Surgeons to Put Gunshot Victims Into Suspended Animation”, Published April 2, 2014 by Robin Marantz Henig, National Geographic.

Also, part of the inspiration for Dr. Peter Rhee's research came from anecdotal accounts of people surviving for hours in frigid water, usually after having fallen through thin ice into a lake.

This common thread of cold, near freezing water made Dr. Rhee realize that if a solution could be developed to cool the body down the same temperature of frigid water, around 10ºC (50ºF), without crystal damage, he could prolong a person’s life by placing them in a state of Suspended Animation. This would allow emergency surgery to commence on their lifeless body to repair tissue damage and do surgical operations.

Saline was chosen as at 10ºC (50ºF), it still a liquid and doesn’t form harmful crystals that can damage living cell tissues. Additionally, Saline is commonly used with patients to stabilize them after they've experienced trauma and has no ill effects on the patient.

What Dr. Peter Rhee basically did next was to simulate such an injury with these Pigs. Then he replaced their Blood with cooled Saline at about 10ºC (50ºF), the same temperature as very cold Tap water. This slowly cools down the Heart and brain first to avoid brain damage. Then as Saline circulates through the rest of the Pigs body, their body soon falls to this super-cooled state. At which point the Pig will have no Blood and basically be dead for anywhere from 1 hour to four hours (1-4hrs).

Dr. Peter Rhee then resuscitated the Pigs by reinfusion their body with their own Blood and slowly warming them up to room temperature, jump starting the Pigs Heart in some cases. Amazingly, the Pigs returned to full functionality with no brain impairment or loss of cognitive or physical function or displaying any limitations in movement whatsoever.

Dr. Rhee’s Emergency Preservation and Resuscitation is historic, folks, as if you read what happened here carefully, you'd realized that these Pigs in his experiment were basically dead for four hours and then brought back to life in 2 hours.

This means that the definition of being dead now has to be redefined, as technically speaking, persons declared dead can now be saved by this technique, to quote Dr. Peter Rhee: “After we did those experiments, the definition of 'dead' changed. Every day at work I declare people dead. They have no signs of life, no Heartbeat, no brain activity. I sign a piece of paper knowing in my Heart that they are not actually dead. I could, right then and there, suspend them. But I have to put them in a body bag. It's frustrating to know there's a solution”.

Please note that this has to be done within the first five to fifteen (5 to15) minutes of Cardiac Arrest for the patient to have any chance of Survival, effectively bringing them back from the Dead, so to speak! So you can see the reason for the excitement over Human Trials for EPR-CAT, which might be expanded to the University of Maryland.

Emergency Preservation and Resuscitation – Surgeons buy time to save Lives and Brain Cells

Now on to the Human Trials!

In the Human Trials led by Dr Samuel Tisherman, when a patient with one with cardiac arrest due to penetrating wounds and significant Blood loss i.e. dead on arrival due to gunshot or knife stabbings, is rolled into the UPMC Presbyterian Hospital in Pittsburgh, Pennsylvania, the next of kin are advised of the options they have.

This may sometimes be a problem, as many times the next-of-kin or spouse with the rights to make decisions on the persons behalf may not be nearby. The options in this case are to put out the word via Traditional and Social Media for members of the Pittsburgh, Pennsylvania to attend Town Hall Community meetings. There the doctors can explain the new procedure and get volunteers to wear bracelets in case they get shot as stated in “Suspended Animation? Docs Try Stopping Clock to Save Lives” published May 25 2014 BY LINDA CARROLL, NBC News, albeit this has proven to be largely unsuccessful.

Ultimately, the final word rests with the USFDA (Food and Drug Administration) giving go-ahead to waive informed consent in the case of a life-threatening emergency. This is a situation similar to USFDA “compassionate use” regulation as it relates to Experimental untried and untested experimental Drugs.

Such was the case of the use of ZMapp, developed by biotech firm Mapp Biopharmaceutical Inc that was administered to American missionary worker for Samaritan’s Purse Dr. Kent Brantly and Nancy Writebol, saving their lives as explained in my blog article entitled “Jamaica's Ebola Risk - How a ZMapp cured Americans of Ebola as Jamaica can become Guinea Pig to Test an Ebola Cure”.

These first five to fifteen (5 to15) minutes of Cardiac Arrest are crucial, as the next-of-kin or spouse with the rights to make decisions on the persons behalf may not be nearby. If close, they have to make the call so that the FDA will have an easier time approving the EPR-CAT, saving some 2 million Brain Cells per minute from dying!

EPR-CAT  - How the Procedure works as Aliens meet Flatliners to enable Suspended Animation

One of these options are utilized and informed consent is waived, Dr Samuel Tisherman can go ahead and begin the use of EPR-CAT on the patient as describe in “Gunshot victims to be suspended between life and death”, published 26 March 2014 by Helen Thomson, New Scientist.

After standard open-chest manual manipulation to restart the Heart fails as close chest CPR doesn’t work on some who's lost a lot of Blood. The team then goes ahead with EPR-CAT with procedure beginning by opening up the chest cavity and clamping the lower rejoin of the Heart, Then the surgical team will thread a large Catheter into the Aorta or main Heart Artery and the Blood is infused with 10ºC (50ºF) Saline.

As the Heart pumps it along, it will first chill the Heart and Brain as the Heart and Brain are chilled first so that their functions slow down and thus demand less oxygen and thus less Blood.  At this point, the clamp is removed so that the Saline can begin to circulate around the rest of the body for 15 to 20 minutes until the entire patient is at the same temperature.

The rest of the Blood is removed from the body, leaving it without Blood as breathing and Heart pulse basically stop. Why this is so isn't quite clear, as pure Saline has no dissolved oxygen in it. Possibly the fact that the water contain NaCl(aq) takes it transmit heat better as via circulation of the 10ºC (50ºF) Saline through the body, it's rapidly removing heat from every part of the body that receives Blood, effectively putting the body in a so-called state of Suspended Animation for up to 4 hours.

At this point, no Blood is in the patient, only Saline, something Jehovah's Witnesses can rejoice about, as if the patient bleeds, it’ll be mainly Saline. This makes transfusion a simple matter of using more Saline.

During this time, the surgeons can get control of any bleeding by repairing major injuries such as arteries, muscle and tissue at the entry point of the bullet or knife. EPR-CAT reduces the need to use Blood Transfusions and has the nice side effect of saving the hospital on the use of Blood that can be utilized for other lifesaving procedures.

Because this can be done for up to 4 hours and then revive the patient, it opens up the possibility of its application of other types of Surgery and may one day eliminate the need to even use Blood Transfusion in surgery altogether. When the surgeons have made all the repairs that they can, they then re-infuse the patient’s own Blood, which has also been chilled slightly above 10ºC (50ºF).

The patient is slowly warmed up back to their regular body temperature of 32ºC (89.6ºF), a process that can take up to two hours. At that point their Heart should automatically starts beating, otherwise they may have to artificially restart their Heart electrically using EPR (Electro-Pulmonary Resuscitation).

The patient will reawaken and like the Pigs in Dr. Peter Rhee’s experiment return to full functionality with no brain impairment or loss of cognitive or physical function or displaying any limitations in movement whatsoever.

So will this research lead to its usage in Space Travel to distant exoplanets that support life as envisaged in my blog article entitled “Dr. Robert Wittenmyer Team discovers Gliese 832 c – Supersize my Exoplanet Please with a Serving of Super-Venus”? That’s what’s got me excited, as like Sigourney Weaver, I dream of going asleep and awakening in a few years in a New Star System, preferably one free of Aliens with Acid for Blood.

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