Ice Cold Saline Has Been Used to Rapidly Cool and Suspend Bodies During Surgery

Doctors at the University of Maryland School of Medicine have placed humans in suspended animation and this could enable them to have hours instead of minutes to operate on critical patients.

They rapidly cooled a patient’s body down to ten to 15 degrees Celsius (50 to 59 Fahrenheit) by replacing their blood with an ice-cold salt solution. Without cooling the patient would suffer irreversible damage in about five minutes.

Emergency Preservation and Resuscitation for Cardiac Arrest from Trauma (EPR-CAT)

Principal Investigator: Samuel Tisherman, MD, professor of Surgery and director of the Division of Critical Care and Trauma Education at the University of Maryland School of Medicine.

University of Maryland School of Medicine faculty researchers at the R Adams Cowley Shock Trauma Center are participating in a research study to test whether Emergency Preservation and Resuscitation (EPR) — a new medical procedure that cools the whole body— can improve outcomes for patients who suffer cardiac arrest due to massive blood loss. Any patient arriving at Shock Trauma who suffers a cardiac arrest after a penetrating trauma such as a gunshot or stab wound were eligible to be enrolled in the study. EPR may preserve the body’s organs (specifically the brain and heart) during cardiac arrest and “buy time” for surgeons to find and repair injuries.

Background
Traumatic injuries, like those caused by car accidents or a shooting, are the leading cause of death in people under the age of 45. The main reason for death is losing too much blood. When the body loses a lot of blood there may not be enough blood left in the body for the heart to pump, which can cause the heart to stop beating (cardiac arrest).

EPR involves administering a large amount of cold fluid to cool patients to around 50°F. Doctors then try to find and stop the source of bleeding. A heart-lung bypass machine is used to restore blood flow to vital organs and warm the body back up.

EPR patients would have otherwise died – fewer than 5% generally survive currently.

Hypothermia is…Currently used for cardiac bypass surgery to protect the brain and other organs when blood flow is paused.

23 thoughts on “Ice Cold Saline Has Been Used to Rapidly Cool and Suspend Bodies During Surgery”

  1. I saw that movie! It turned out . . . badly.

    On the other hand, if we can eventually record and reload minds then, along with nanobot technology, stem cells, and maybe a bit of AI, there is no reason to believe it would be impossible to bring almost anything back to life, although past a certain point it might be more honest to call the resulting person a replacement, rather than a resurrection.

    It would do the original little good but friends would probably prefer it. And the families would probably insist on it if the tech is available and they have the resources to do it.

    If we figure out how to do this then, like everything else, we will do it first, then worry about the social and environment impacts later — and we will get eventually get those resolved as well.

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  2. Complete shutdown of neural activity is the definition of brain death, and a step down from the vegetative state (some autonomic functions still active, hence some organs may still function). As such, brain death is often the demostrable basis for legal death.

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  3. Look, I have to say that you’re objectively wrong. Many people have been through procedures which totally shut down neural activity, and when it resumed, they weren’t blank slates.

    Yes, synaptic transmission is chemical. But memory is stored in physical changes to the synapses, (and other structures.) not transient chemical concentrations. If you still remember something five minutes from now, you’re not going to forget it just because your brain gets shut off for a while.

    It just, objectively, demonstrably, doesn’t work that way.

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  4. Synaptic transmission is not electrical, it is chemical. No chemicals, no transmission. No transmission, no more memory. Synapses are not static memory, they are dynamic memory. The brain cannot reboot, it is not a computer. It grows physically, 2~3 synapses per neuron per day are formed and unformed continuously. More in the young, much more in childen. In that dynamic balance all memory exists – always about six minutes away from going bad. If synaptic transmission stops due to neuron starvation, there is nothing to resume after.

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  5. Just because we don’t know how to do a thing doesn’t mean it is impossible. I think we should investigate bringing the dead to life. We don’t even have to start with people.

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  6. Yes, I got some of the details a bit wrong. But the point remains, re-perfusion is fairly straightforward if the ischemia is pre-planned and executed properly. This myth about brain cells dying after only a few minutes without oxygen is mostly due to the difficulty of reestablishing blood flow after natural ischemia.

    I’m mostly familiar with the application to cryonics. The ice cold saline procedure they describe here is similar to the early stages of cryonic suspension. Alcor has taken dogs down to profound hypothermia, and kept them without any heart beat or neural activity for easily as long as described in this procedure, and then gotten them up and walking around again, seemingly no worse for wear.

    “Cooling yes but you’re not going to drastically drop energy levels with barbs on board.”

    It’s called “induced coma”. You put the patient on intensive life support and administer barbiturates until their EEG flatlines. This dramatically reduces the brain’s metabolic demand. The cold helps in that regard, too.

    http://www.neuroanesthesia.info/cerebralprotection.htm

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  7. What you described is at the level of arterioles. Capillaries have no muscles around them as it would impede nutrient/O2 diffusion.
    “Secondly, if you’re going to shut off circulation to the brain, you typically want to induce a barbituate coma first, to dramatically reduce energy loads on the cells. ”
    I have…never, ever heard of that being used in practice. Cooling yes but you’re not going to drastically drop energy levels with barbs on board. They induced “downer” neurons by the same mechanism as ethanol, yes, but not like you’re describing.

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  8. Yea but what you described is at NORMAL body temp. Not reduced temp where metabolic processes are slowed down.
    So neurons would have a longer time of viability before apoptosis.

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  9. I wonder what the heart rate is at the 15 deg C. Or do they pump the solution at some constant speed using outside pumps only, and then they restart the heart after the surgery? There is very little information given in the links to that report.

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  10. There is a technique called medically induced torpor that has already been used on certain patients for decades. It is a lot less invasive and it helps a lot with the problems mentioned above too.

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  11. I believe that there is a technique of placing a biological specimen in freezing solution while vibrating the tissue with ultrasound. The tissue gets below freezing temperature but crystals are not formed because they are being vibrated. Then the ultrasound is turned off and the tissue freezes without large ice crystals forming because they haven’t had time to form. So, if a larger organism had surgery to open ports throughout the body and multiple ultrasound probes were inserted throughout the body and turned on and then the subject was placed in freezing solution, perhaps the full body could be frozen indefinitely without damaging it (beyond needing small surgical repairs) and then it could be reanimated safely.

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  12. Yeah. This really isn’t news as far as I can tell. This sort of thing has been done with stroke and heart attack victims. The news report is pretty limited re: the procedure but it appears to not be anything new.

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  13. The brain can survive for an hour in a hyperthermia state … there are cases of people falling into frozen lakes drowning and then being resuscitated an hour later…. the only problem here is that it can’t be so cold as to create ice cystals that shred cells into pieces,,,,

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  14. I agree that it isn’t really a matter for debate, people and other higher mammals have been put through this sort of procedure over and over, without long term ill effects from it. (Though the medical issues that prompted doing it may still have consequences.)

    Interruption of electrical activity in the brain really has no long term consequences except loss of short term memory; Any memories that have already been processed to long term memory remain intact.

    The brain basically just reboots when neural activity resumes.

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  15. Neuron physiology is not a matter for debate, I simply stated a known fact (learnt from the person eminently experienced, in theory and experiments, to lecture on the subject). They lose signals, they lose synaptic signaling – signal network falls apart, also known as “memory” (at all levels, not just your name, but also motor: how to walk, speak, etc). In the end, it does not matter why synaptic signals were lost. Even when doing nothing, brain needs energy to maintain synaptic signals (they are chemical). About 9% of all energy when doing absolutely nothing. Cut that energy supply, and count 6 minutes till it does not matter. The rest of body (them expensive organs) may be OK after that. You may refer to hypothermia — with slowed but continuing blood circulation. In that case, less important blood vessels can constrict, effectively redirecting blood to priority circuits. Without blood, even if that saline is oxygenated, there is nothing for brain to go on.

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  16. “Neurons have about six minutes to go on if blood circulation stops.”

    Feh. Not really. There’s a whole cascade of events that take place when blood circulation is cut off to the brain. A critical one of these is that, when enough oxygen has been used up that oxidative metabolism shuts down, ion pumps in the cell membranes shut down, and the electrolytic environment within the cells changes.

    This can cause muscle cells lining the capillaries to contract, pinching the capillaries shut, which prevents reperfusion. So that even if the neurons would be fine if you reestablished circulation, you can’t get the blood flowing again.

    Now, if you perfuse the brain with a fluid that contains a calcium channel blocker before this can happen, the capillaries stay open, and there is no obstacle to reperfusion.

    Secondly, if you’re going to shut off circulation to the brain, you typically want to induce a barbituate coma first, to dramatically reduce energy loads on the cells. Cooling also does this.

    Thirdly, as temperature drops, different ion channels stop working at different points. So the ion composition of the perfusate has to be varied with dropping temperature. Eventually you want it to match typical intracellular levels, because there are proteins inside the cells that can be denatured if they’re exposed to the wrong concentrations of electrolytes.

    It’s all pretty complicated, but if you do it right, neurons are good for a couple hours easy without circulation, not six minutes

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  17. If the patient already lost a lot of blood, the lost blood needs to be replaced anyway. Saline is a quick fix that in this case also allows quick cooling. I think the result is dilution of the blood instead of complete replacement. Human blood completes about one full circulation per minute, so even with no mixing, you will get intermittent switching between blood and saline every few seconds.

    It may be better to use a more advanced saline replacement that can carry oxygen and nutrients, but in an emergency it may be enough to just add some glucose. Another option is to use chilled blood transfusions instead, but then you need to make sure you’ve chilled the right type of blood.

    For patients who didn’t loose much blood, it may be possible to run their own blood through a heat exchanger to cool it rapidly.

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  18. Needless to say, the consequences of complete removal of blood from human body are completely unknown. Long term, short term, genetic, all kinds of consequences. Blood is not exactly an optional item. Obviously, consequences are better than bleeding to death, but there absolutely must be consequences – all of them bad. So in the end it may be pointless.

    For example, there are no nutrients in saline solution. Neurons have about six minutes to go on if blood circulation stops. After that, synaptic loss starts (all over nervous system), and the result of a surgery could be a vegetable, some organ failure, paralysis or something. That makes me guess if all the fuss is about facilitation of organ harvesting.

    “We have done all we could, even cheated death, but your spose/child suffered irreversible brain damage. We are so sorry. Incidentally, may we suggest organ donation? Here is a list of people who are eagerly waiting for fresh meat. Oopsie, those 24 hour shifts on stims make one a bit lightheaded. I meant your generous organ donation. Sign here, and we will readily absorb all incurred medical costs. Here is your bill.”

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