Doctors can now save ER patients' lives by suspending their heart and brain function
Suspended animation isn't just a trick to keep characters alive in science fiction — at least, not anymore. According to a report from New Scientist, doctors have managed to successfully place humans in a suspended state, effectively pausing their bodies and minds while medical procedures are performed. The technique, known officially as emergency preservation and resuscitation (EPR), could allow medical professionals to perform potentially life-saving operations on people suffering from acute trauma.
The details on the procedure, including how many people it has been attempted on, remain vague for the time being. New Scientist cited Samuel Tisherman, at the University of Maryland School of Medicine, who said that his team of medics have successfully placed at least one patient in suspended animation. There was no indication as to exactly how many people the procedure was attempted on, how many times it has succeeded or how many times it has failed. But the fact that it has apparently been used to prevent the death of at least one person suggests the possibility that EPR could become a technique used to save more lives when people experience life-threatening injuries.
Thus far, suspended animation has only been attempted on people who are already in a rather dire situation. It has reportedly been used on people who have arrived at the University of Maryland Medical Centre in Baltimore and are suffering from acute trauma like a gunshot or stab wound. The patients in these cases have already succumbed to cardiac arrest — which can result in the sudden loss of heart function, breathing, and consciousness — and half lost as much as half of their blood. Under those circumstances, doctors only have a matter of a few minutes to operate and the patients are given less than a five percent chance of survival.
Under normal circumstances, the body would be at 37 degrees Celsius or about 98.6 degrees Fahrenheit, which requires cells to constantly receive oxygen in order to produce energy. When cardiac arrest occurs and the heart stops operating as expected, the patient's blood stops carrying oxygen to cells, which leaves a limited time in which the operation can be performed in order to stop irreparable damage from being done to the body. In order to extend the time frame in which doctors can potentially save the patient, the medics perform the EPR technique. This requires the patient to be rapidly cooled down to between 10 and 15 degrees Celsius, or between 50 and 59 degrees Fahrenheit.
To get a patient to this temperature as quickly as possible, the doctors replace their blood with a cold saline solution. During the process, the person's brain activity almost entirely ceases, resulting in a state that would typically have the patient declared dead. Instead, the patient is moved to an operating theater where doctors now have as long as two hours to address their injuries. At that point, the body is warmed up and the person's heart is restarted, with the ideal result that everything returns to full operation, avoiding any of the long-term damage that the traumatic injury would otherwise cause.
The concept for this suspended animation technique isn't exactly new. Studies of similar procedures have been performed on animals and found that the cooling methods could be used to provide as much as a three-hour window during which an operation could be performed before the animal is resuscitated. A trial performed on pigs resulted in 90 percent of the animals surviving. That trial, carried out on 40 pigs all the back in the year 2000, found that none of the surviving animals sustained cognitive or physical impairment following their resuscitation. None of the control pigs in the same study survived the initial injury.
Doctors have kicked around the idea of suspended animation for humans for decades, but haven't experimented in any viable way until now. In fact, Tisherman — the person behind the current trial — has been pushing for the procedure to get wider testing since at least 2014. The team behind the suspended animation technique being used has been given approval by the U.S. Food and Drug Administration (FDA) to carry out a trial on 10 people to test the feasibility of the procedure — though the process is somewhat controversial. In order to carry out the trial, the FDA has exempted the team performing the EPR technique from getting patient consent. The reason for the pass is that the patients in the trial have suffered from injuries so severe and likely to be fatal that alternative, more common procedures are extremely unlikely to succeed. Those operating the trial have reportedly placed ads in newspapers in the communities around the University of Maryland School of Medicine, where the experiment is being performed, directing them to a website where they can opt out of the procedure if they are brought into the hospital for a traumatic injury. But most patients won't get the chance to choose whether they undergo EPR or not — the doctors will decide if it gives them a better chance at saving the person and will use it to extend the window during which they can perform the potentially life-saving procedures. It is expected that full results of the study will be released sometime in 2020.
What Tisherman and his team are doing isn't quite the stuff of sci-fi just yet. In fact, in an interview with New Scientist, Tisherman specifically says "I want to make clear that we're not trying to send people off to Saturn," referencing fictional depictions of suspended animation used for concepts like long-term space travel or cryogenic preservation. Instead, the technique is for meant for immediately addressing the needs of a patient who is on the brink of death. It's possible that the technique could open up the possibility of those more fanatical uses in the future, but that isn't even remotely on the mind of the doctors carrying out EPR currently. "We're trying to buy ourselves more time to save lives," Tisherman said.
