DailyTech - Critical Patients in Boston Could be "Frozen" Before Surgery

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Science Critical Patients in Boston Could be "Frozen" Before Surgery
Tracie McDaniel - September 29, 2010 5:13 PM

42 comment(s) - last by bh192012.. on Oct 1 at 1:45 PM

Ground-breaking technique will place trauma patients in a state of suspended animation.

Trauma patients in Boston could soon be treated very coldly by doctors. Researchers from the Harvard Medical School and the Massachusetts General Hospital in Boston plan to begin the first human trials for placing patients in a state of suspended animation during surgery.

The new method requires doctors to replace a patients blood with a cold saline solution that would quickly chill the body's temperature. This new procedure induces extreme hypothermia in trauma patients, freezing bodies to the point of death according to the Telegraph.

The new process would completely shut down bodily functions and provide surgeons with more time to operate. Those conducting the research expect that placing patients in suspended animation will to help reduce the need for life support and anesthetics and would reduce damage to the brain and other organs.

"If you drop the body's core temperature and brain temperature down to 15 degrees C or 10 degrees C you are talking about 60 minutes and even 190 minutes of protection," said Massachusetts General Hospital's Dr. Hasan Alam.

The normal human body temperature is 37 degrees C. Under normal circumstances, if the core body temperature drops below 22 degrees C brain death would be expected to occur.

"By cooling rapidly in this fashion we can convert almost certain death into a 90 percent survival rate," said Alam.

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By YashBudini on 9/29/2010 6:26:36 PM , Rating: 2

I had heard (can't be sure) that if AIDS was on the tip of your finger it would die.

Would AIDS survive this process?

RE: ??

By Oobu on 9/29/2010 6:37:12 PM , Rating: 2

You have an interesting point.

http://wiki.answers.com/Q/How_long_does_HIV_live_o...

Seems like a reasonable question to me.

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RE: ??

By axeman1957 on 9/29/2010 7:25:46 PM , Rating: 2

But if that were the case, why would blood banks turn someone away for being HIV+? I think the exposure to oxygen is the bigger killer, not temperature (note in the link, it states the virus can live in a needle if it does not dry out)

That said, it is an interesting idea to replace a body's blood with a saline solution temporarily and treat their blood in some way to kill the virus

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RE: ??

By PCR on 9/29/2010 7:34:30 PM , Rating: 3

Can't kill the HIV virus that way! exposure to oxygen does nothing either, temperature actually would denature the virus relatively quickly. That is how most things are sterilized, using heat, even surgical equipment.

The HIV virus integrates its RNA into the genome of the infected person, not going to delve into details here but basically the virus would just replicate itself after a fresh blood transfusion.

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RE: ??

By MozeeToby on 9/30/2010 10:16:46 AM , Rating: 2

HIV integrates RNA into white blood cells , if you could somehow (and this is the impossible part) remove 100% of the a patient's blood and replace it with HIV-free blood (or better yet, blood from someone who is resistant to HIV) you could in theory cure the disease.

Of course, you're never going to get every drop of blood out of every capillary in the human body, it's just not possible (though I wonder if it wouldn't be possible to dilute the virus enough that a cocktail of drugs could eventually eliminate it the same way that it can prevent HIV after the initial exposure). No, the way to use this technique to actually cure a patient is to irradiate their bone marrow and replace it with marrow from someone who is HIV resistant. This has been done and been people treated this way are still HIV free years later. The problem is that bone marrow transplants, especially in someone already immunocompromised, is an incredibly risky procedure.

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RE: ??

By Everyone on 9/30/2010 1:23:14 PM , Rating: 2

This is correct, although it is important to realize that, despite the name, white blood cells are not located solely in the blood. There are large resevoirs for instance in the lymphatic system. (HIV actually targets the subset of WBCs known as lymphocytes). While lymphocytes are located largely in the blood, their role as pathogen fighters means that they have to travel to nearly every place in the body.

By replacing the bone marrow of a patient, you would replace the progenitor cells of the patient's white blood cell population... future white blood cells would be free of HIV, assuming you could pair the replacement with treatment capable of eliminating the infected cells already in a patient's system. If you were to leave infected cells in the mature WBC population, there is always a chance that they could re-infect the new WBCs and start the process all over again. As mentioned above, the 'dilution' idea has been shown to be effective, but is also impractical for the given reasons.

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RE: ??

By chagrinnin on 9/29/10, Rating: -1

RE: ??

By MozeeToby on 9/30/2010 11:46:56 AM , Rating: 2

No, it raises the question. Begging the question is assuming the answer to the question that best supports your argument.

[/grammar Nazi rant]

(and I really do apologize for it, but this one really bugs me)

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RE: ??

By chagrinnin on 9/30/2010 1:22:31 PM , Rating: 2

Which begs another question,...

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RE: ??

By YashBudini on 9/30/2010 1:21:49 PM , Rating: 1

quote:
Which begs the question,...who's been cumming on the tip of your finger?

quote:
You don't know where that finger's been.

Sniffing his finger from "Airplane."

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RE: ??

By chagrinnin on 9/30/2010 2:07:37 PM , Rating: 2

Ahhh. Surely, I'd rate you up if I could. :P

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RE: ??

By JAB on 9/29/2010 7:24:11 PM , Rating: 2

Yes it should work well getting it approved for research is another story Expect this treatment in the next 10 years after it has made its way though the legal process if this works.

An arctic sun would work just fine if they set it up for these temps. These are easy to use. Some hospitals already use the arctic sun for hypothermia treatment for traumatic brain injury to decrease O2 demand. The temp is lower than we usually use now in the ICU but we already use this kind of thing. I suspect temps at or slightly below we commonly use would be effective. Worst case you could do this in the OR by a Perfusionist they already use temps well below AIDS killing range. The big hurtle is legal- beware a lawyer on commission.

Approval for anything other than a trauma or heat attack patient would be a massive legal hurtle even if completely safe and effective so dont hold your breath. I am sure it will come in time though.

http://en.wikipedia.org/wiki/Arctic_Sun_medical_de...
http://www.medivance.com/

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RE: ??

By lolmuly on 9/29/2010 10:17:22 PM , Rating: 2

HIV is a virus and is not alive, it is more of an extremely complex molecule that injects itself into other cells. Virus's change the dna, and the cells then produce copies of the virus. A cell once infected would have to be killed (or alternatively have its dna changed back) in order for a person to be cured of infection.

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RE: ??

By vol7ron on 9/29/2010 11:28:34 PM , Rating: 2

Is that what happens with zombies?

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RE: ??

By lolmuly on 9/30/2010 2:29:59 AM , Rating: 2

haha no, zombies don't have any basis in physical reality.

Cells need a constant supply of oxygen to survive (or alternatively they have to be put into suspended animation), and since their heart stops beating even if you could keep the brain functioning, after about 30-40 their muscle tissue would be unusable so they couldn't move.

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RE: ??

By tng on 9/30/2010 9:48:14 AM , Rating: 2

Missed the sarcasm there did we?

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RE: ??

By ppardee on 9/30/2010 12:42:14 PM , Rating: 3

HERESY! Zombies DO exist! I have seen them wandering the streets of downtown Tempe near ASU at 2:30am. They are usually using iPods, so I'm thinking it’s some sort of Weekend-at-Bernie’s style locomotion, but they stumble about and make incoherent sounds. Gotta be zombies.

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RE: ??

By PaterPelligrino on 9/30/2010 2:22:06 AM , Rating: 2

As I understand it, the HIV virus dies outside the body because it cannot survive in a dry environment, so lowering the temp of the blood that contains it would not kill it.

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RE: ??

By AnnihilatorX on 9/30/2010 5:31:32 AM , Rating: 2

Don't use the term die with a virus. Virus by definition are not alive. They are chemicals. Use the term 'destroyed'

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RE: ??

By PaterPelligrino on 9/30/2010 6:14:28 AM , Rating: 2

I admit that I didn't pay much attention to language in that post, but the issue of whether viruses are alive or not is still being argued. I do agree, however, that a virus not in contact with a living cell is not alive.

Here's the inevitable Google search quote:

"Viruses exist in two distinct states. When not in contact with a host cell, the virus remains entirely dormant. During this time there are no internal biological activities occurring within the virus, and in essence the virus is no more than a static organic particle. In this simple, clearly non-living state viruses are referred to as 'virions'. Virions can remain in this dormant state for extended periods of time, waiting patiently to come into contact with the appropriate host. When the virion comes into contact with the appropriate host, it becomes active and is then referred to as a virus. It now displays properties typified by living organisms, such as reacting to its environment and directing its efforts toward self-replication".

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RE: ??

By quiksilvr on 9/30/2010 11:14:42 AM , Rating: 2

By that logic, we could call humans a virus. We are just chemicals, after all.

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RE: ??

By YashBudini on 9/30/2010 1:18:55 PM , Rating: 2

Thank you Agent Smith.
:-)

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RE: ??

By bh192012 on 10/1/2010 1:39:11 PM , Rating: 2

Exactly, you don't see us replicating when we're not in our proper environment.

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RE: ??

By tmouse on 9/30/2010 9:23:15 AM , Rating: 2

I cannot speak specifically for HIV but many virus containing serums can be kept a -80 for very long periods of time and still be infectious. Also this would have absolutely no effect on infected cells, they obviously survive else the patient would die so any virus in them will also survive.

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I don't get the logic

By vol7ron on 9/29/2010 11:32:44 PM , Rating: 2

quote:
If you drop the body's core temperature and brain temperature down to 15 degrees C or 10 degrees C you are talking about 60 minutes and even 190 minutes of protection...Under normal circumstances, if the core body temperature drops below 22 degrees C brain death would be expected to occur.

So we're saving them by killing them?

... doesn't really describe how they are resuscitated.

RE: I don't get the logic

By Rubinsson on 9/30/2010 4:14:01 AM , Rating: 2

As far as I have understood the heart will begin to beat by itself as the temperature rises again(look at heart transplants). The heart(and other organs) must be relatively undamaged by the cooling and the fast cool down protects the cells by making them stop consuming oxygen.
Ironically oxygen is both a killer and a lifesaver in advanced organisms...

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RE: I don't get the logic

By Mitch101 on 9/30/2010 8:36:50 AM , Rating: 2

Russia has been doing this for a while finally made it to the US.

http://www.uchospitals.edu/news/2001/20010510-beck...

2001
"In Russia, people are packed in ice, cooled until the heart stops, and then have open heart surgery without blood flow, while in the United States, cardiopulmonary bypass is used during heart surgery,"

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RE: I don't get the logic

By MrBlastman on 9/30/2010 9:33:32 AM , Rating: 2

I've actually been through this process, or a similar one. I was cooled to about 50 degress Fahrenheit (or 10 degrees Celcius). What happens is the metabolic functions of the brain essentially shut down to near zero activity, thus the oxygen requirements for the cells is reduced significantly as well.

In a situation where acute blood loss is an issue, reducing their temperatures significantly will give the doctors far more time to both procure enough blood for a transfusion and, more importantly, suture/cauterize the tramatized area that is leading to the blood loss. You don't want to go pumping blood into them if it is going to just leak out!

Typically in a procedure like this, the body is hooked up to a heart/lung machine to provide some oxygenation to the blood that is flowing through the system so the minimal amount that is required is provided. Once the wounds are repaired, the heart can then be brought back online and the body can be gradually raised in temperature.

The resuscitation is actually the tricky part, believe it or not. "Freezing" (well, you aren't really freezing them but you get the idea) them is the easy part, as you can do it very quickly. The re-heating of the body though, has to be done very slowly. The reason is if you heat the body too quickly, micro-bubbles form in the blood which could lead to them having a stroke. Therefore you have to heat them extremely slowly over a period of several hours to prevent this.

This is done every day, actually, in operating rooms around America, except, not to save people of traumatic injuries. It is usually used in open-heart surgery (this is what I had to repair an aneurysm) and it does have a side effect or two after the fact. There might be some nerve damage to the area hooked up to the blood-processing machine (this typically resolves over time) and curiously, I find that in the first year after surgery I was extremely sensitive to cold temperatures. I have been warm-natured my whole life, however, after surgery, my body did not like being cold at all. I think this symptom has regressed back to normal over time--though it has been slow and I'm still not quite back yet to being completely warm natured.

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RE: I don't get the logic

By vol7ron on 9/30/2010 10:44:45 AM , Rating: 2

That's an interesting side effect. You were technically dead due to low temperature and now your body is telling you it doesn't like the cold :)

I thought I saw somewhere that you can freeze then unfreeze the body because the blood crystalizes. Though you're stripping out almost all the blood, wouldn't this still cause problems in the muscles and different cell walls?

quote:
The resuscitation is actually the tricky part, believe it or not.

I believe the resuscitation is the tricky part... it's easy to kill someone, it's hard to bring them back to life. Plus, you could have a heart attack.

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RE: I don't get the logic

By Mitch101 on 9/30/2010 11:47:39 AM , Rating: 2

I saw a show on discovery on how frogs survive the winter being frozen. Because of the high sugars in their blood stream it prevents the ice from becoming razor sharp and piercing cells like a dagger which are impossible to repair in the bulk of a typical freezing and ice formation.

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RE: I don't get the logic

By MrBlastman on 9/30/2010 11:54:11 AM , Rating: 2

I think I saw that same show--or at least read about it. They can survive for extended periods of time like this, it is pretty darned amazing.

Our bodies though, sadly, would be torn apart if proper preservative agents weren't first put into the blood (and absorbed by our cells). I believe in the freezing centers where people pay large sums to have their bodies (or heads--Futurama ;)) frozen, they are first treated in a solution to prevent these ice crystals from compromising the cellular walls.

If the blood freezing doesn't tear things up, the rupturing of the cell walls from within will do it as well. A good analogy is trying to grill a hamburger with fresh meat versus frozen meat. Fresh meat isn't runny and it clumps together real well making a solid patty that doesn't fall apart. Frozen (and thawed) meat, on the other hand, squirts out quite a bit of juice while kneading it, falls apart easily and is very difficult to keep intact when you put it on the grill. The fresh meat will typically grill to be very juicy, while the previously frozen meat has a tendency to be much drier. This is all due to the cell walls of the frozen meat being compromized in the freezing process.

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RE: I don't get the logic

By bh192012 on 10/1/2010 1:45:53 PM , Rating: 2

So we need to be eating frozen frogs or sugar plumped cows?

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RE: I don't get the logic

By Mitch101 on 9/30/2010 11:39:24 AM , Rating: 2

Congrats on surviving an aneurysm and sharing the info.

I'll take a few side effects over the alternative.

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RE: I don't get the logic

By MrBlastman on 9/30/2010 11:55:05 AM , Rating: 2

The side effects are much better than the alternative. :)

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freezing...

By RivuxGamma on 9/29/2010 8:21:03 PM , Rating: 2

I just want to point out that this is not actually freezing anything. It's just chilling them very rapidly.

Also, I would hate to be awake when they did that.

RE: freezing...

By Mitch101 on 9/30/2010 8:50:04 AM , Rating: 2

Its Shrinkage!!!

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RE: freezing...

By thrust2night on 9/30/2010 10:01:21 AM , Rating: 4

I was in the pool, I was in the pool!!!

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How long till we can keep them suspended for years?

By peter7921 on 9/29/2010 6:21:53 PM , Rating: 3

This is very exciting news. I wonder how long till we can keep bodies frozen in suspended animation for months and even years?

Corpsicles..

By TeXWiller on 9/29/2010 7:39:54 PM , Rating: 2

A way to reduce the waiting times in an ED or Minor care units. In the headlines: patient goes in having a cold, ends up in cold. Joking aside, freezing should improve the capacity and capability of a small hospital to the point of actually being able to handle a small terrorist attack.