By Aditya Nair
Modern medicine may be headed into the future. A revolutionary new technique is being tested at the University of Pittsburgh Medical Center Presbyterian Hospital to improve the outcomes of victims of massive blood loss by, almost ironically, bringing the patient as close to the brink of death as is safely possible.
By pumping cold saline directly into the patient’s aorta, surgeons aim to cool the patient’s body temperature to around 50 degrees Fahrenheit. This allows the brain and the heart to recover more efficiently, serving as a damage control mechanism by essentially slowing time down for the body’s cells, giving the cellular machinery a chance to recalibrate its settings. It only takes five minutes for brain cells to begin dying. During a stroke, 2 million brain cells could die for every minute that they are deprived of bloodflow. By cooling the body, it’s possible to slow this rapid brain death. As the surgeon pioneering the method put it, in a blood loss emergency, “time is brain”.
The saline will also allow surgeons to identify areas of extensive bleeding without actual wasting blood, buying surgeons more time to patch the holes and perform the necessary repairs.
Experiments performed on animal models have been largely successful, and scientists report that animals can undergo the process and emerge unscathed. Demonstrating that such techniques work in animals was a key in convincing ethics boards and the scientific community as a whole that suspended animation trials in humans could actually improve outcomes.
The particularly strange part of the plan, however, is that during the cool-down time, the patient’s body will display no apparent signs of life. All of his or her blood will have been drained and replaced with saline solution. There will be no heartbeat. Breathing will stop. Brain functions will slow to a crawl. In fact, the doctors that came up with this process are calling it “suspended animation,” reflecting the fact that while undergoing the process, the patient will neither be alive nor dead.
Similar technology has been postulated as a way to keep future human space travelers alive for hundreds of years to facilitate the exploration of planets, asteroids, and stars. However, for now, the technology can only be applied for an hour at a time.
The initial study will take place upon the next ten eligible massive blood loss patients that present with massive blood loss. If conventional resuscitation methods such as open heart manual manipulation fail, the patients will be treated with the experimental procedure. This raises the question of what “dead” really means, forcing a rewriting of the medical and legal definitions of death.
The study also raises substantial ethical questions, since patients coming to the emergency room with massive blood loss can rarely provide an informed consent. However, the FDA allows research being performed in situations of life-threatening research to proceed without strict informed consent rules. Additionally, the doctors have been hosting town-hall meetings about the procedure that informs the community about the research and allows individuals to wear a bracelet that identifies them as not willing to participate in the research. However, at least as of yet, no bracelets have been requested.