Moderate cooling saving thousands after heart attacks and safe rapid cooling could enable hours of safe surgery without concerns over oxygen deprivation

Rapid cooling and controlling how blood flow and temperature is restored could allow people to be safely oxygen deprived for hours instead of four minutes. In pigs they have restored after 30 minutes. It is not oxygen deprivation which kills cells it is the uncontrolled restoration of oxygen. It can also be used to solve the transplant shortage in 9 months with these techniques. People could be placed into a suspended state.

There are several new inventions for more effective rapid cooling without the downsides of current cooling techniques.

Medical ice slurry protective cooling is based on the premise that the ability of organs and tissue to survive ischemia, reperfusion damage, and surgical insults is improved by cooling rapidly in 5–15 minutes 4–15°C (depending on the organ) below the normal temperature of 37°C. Cooling slows metabolism and reduces the need for oxygen, which slows cell death—providing more time for medical treatment.

Argonne scientists have developed a portable and fully automated prototype for medical slurry production and delivery. The system makes sterile medical ice slurry that is of uniform consistency and is deliverable through narrow catheters. The device not only delivers slurry as needed and tracks the amounts of slurry used and remaining, but it also monitors the temperature of the target organ.

A catheter-based heat exchanger that can be locally placed, with the capacity to ensure that the blood flowing to the local environment is maintained at a specific temperature. This approach would reduce the heat load significantly and would likely reduce the time to target temperature to seconds instead of minutes or hours. There are emerging phase-change tech- nologies that have the promise to significantly reduce cooling time. One device, Rhinochill R, is a nasopharyngeal cannula that mists the nasal cavity with liquid perfluorocarbon. The perfluorocarbon evaporates on contact with the body, facilitating rapid and significant heat transfer. This device has shown promise in both exper-
imental and preliminary human studies. A device developed in our lab creates a pumpable
ice particulate slurry out of medical saline. This ice slurry is a biocompatible phase-change coolant that has almost twice the heat capacity of saline alone.

Mild Hypothermia

Wide adoption of mild hypothermia and slower cooling techniques can save one in six people who die of heart attacks.

Despite many advances in primary and intensive care treatment, not even a third of all patients with a return of spontaneous circulation (ROSC) survive until hospital discharge when the cardiac arrest occurs outside a hospital. Furthermore, the primary mode of death in the post arrest period is neurological failure.

Every year in the United States, an estimated 300,000 patients experience an out-of-hospital cardiac arrest. Ultimately, only 7.9% of those patients survive to discharge. The rate of survival of an in-patient cardiac arrest is also low at approximately 33%. Upwards of 90% of survivors experience permanent neurologic injury.

There were two studies where therapeutic hypothermia (lowering the body temperature) was used to improve outcomes to about 49-50% without brain injury versus 26-39% without therapeutic hypothermia. There was also a decrease in mortality in the hypothermia group (41%) compared to the normothermia group (55%). One in six more people were saved.

There are barriers to the adoption of therapeutic hypothermia

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