Death is still out of science's grasp...

UnchartedSpirit · May 5, 2007

http://www.msnbc.msn.com/id/18368186/site/newsweek/?GT1=9951

Biologists are still grappling with the implications of this new view of cell death—not passive extinguishment, like a candle flickering out when you cover it with a glass, but an active biochemical event triggered by "reperfusion," the resumption of oxygen supply. The research takes them deep into the machinery of the cell, to the tiny membrane-enclosed structures known as mitochondria where cellular fuel is oxidized to provide energy. Mitochondria control the process known as apoptosis, the programmed death of abnormal cells that is the body's primary defense against cancer. "It looks to us," says Becker, "as if the cellular surveillance mechanism cannot tell the difference between a cancer cell and a cell being reperfused with oxygen. Something throws the switch that makes the cell die."
With this realization came another: that standard emergency-room procedure has it exactly backward. When someone collapses on the street of cardiac arrest, if he's lucky he will receive immediate CPR, maintaining circulation until he can be revived in the hospital. But the rest will have gone 10 or 15 minutes or more without a heartbeat by the time they reach the emergency department. And then what happens? "We give them oxygen," Becker says. "We jolt the heart with the paddles, we pump in epinephrine to force it to beat, so it's taking up more oxygen." Blood-starved heart muscle is suddenly flooded with oxygen, precisely the situation that leads to cell death. Instead, Becker says, we should aim to reduce oxygen uptake, slow metabolism and adjust the blood chemistry for gradual and safe reperfusion.
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Terry_Herrington · May 5, 2007

UnchartedSpirit said:

http://www.msnbc.msn.com/id/18368186/site/newsweek/?GT1=9951
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Interesting, but I know the end of the story.

hillclimber1 · May 6, 2007

Now that is fascinating, and I hope they develop the proper procedures before I and mine need them. Great article US.

Gold Dragon · May 6, 2007

Very interesting, especially since I am receiving a talk on CPR this week in school.

Looked up the doctor and UPenn's website has some more info on potential resuscitation treatment proposed by Dr. Becker, including rapid cooling.

Penn Medicine: News Release: The New Science of Saving Lives
...
Dr. Becker’s previous contributions to cardiac care include the development of the automatic external defibrillator (AED). The AED is a device that delivers a shock to restart the heart of a person in cardiac arrest that can be used by non-medically trained personnel.

Initially, Dr. Becker’s new research will focus on extending the five-minute window associated with successful cardiac arrest resuscitation.

...

Dr. Becker’s group will also study the benefits of cooling cardiac arrest patients. Previous studies have indicated that cooling a patient immediately after arrest noticeably improves cell death rates and resuscitation success. Recently, the American Heart Association recommended that every cardiac arrest patient who qualifies should be cooled.

“We have developed a whole program on why cooling saves cells,” said Becker. “Immediate cooling cardiac arrest victims increased their survival by 16%. That’s a very significant improvement which could mean thousands of lives saved each year as we get faster and better at cooling patients. Unfortunately, we don’t know exactly how cooling saves cells, so we will definitely be doing cellular experiments on the mechanisms of how cooling works. The one thing we do know from our lab, the best results require rapid cooling, yet we don’t have a good way to rapidly cool patients.”

To develop more rapid cooling methods the Center for Resuscitation Science will continue to develop a novel cold slurry - a slushy mixture of salt and ice crystals - that can be injected intravenously for rapid internal cooling.

“Our current methods of cooling are far too slow,” said Becker. “Injecting bio-compatible cold slurry is the best way to rapidly drop internal temperature.”

Eventually, the goal is to create a slurry-delivery device that both medically and non-medically trained people could use on cardiac arrest patients to keep them cool during transport to a hospital.

...
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Death is still out of science's grasp...

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