Treating the Dead 246
FlyByPC writes "According to a NewsWeek article, oxygen deprivation doesn't kill patients as much as the resumption of oxygen does. This discovery could bring about new ways of resuscitating people whose hearts have stopped."
I'm continually amazed at (Score:3, Insightful)
What about the brain though. (Score:4, Insightful)
It might be useful so organs could be used for a transplant.
Re:Makes a little bit of sense. . . (Score:3, Insightful)
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Old news -- reprofusion injury (really old news) (Score:5, Insightful)
I wrote about that >20 years ago, when I was writing for a biotechnology newsletter. After >20 years of research, they understand it much better today.
Every surgeon knows about reprofusion injury. You can go to Barnes & Noble and look it up in a surgery textbook.
I don't understand why Newsweek says it's new or that it wasn't known in 1993. I assume those doctors came up with some new detail in its treatment.
Re:Traditional Chinese Medicine Recognizes This (Score:2, Insightful)
Details please. I mean, I'm all against ethnocentrism as much as the next guy, but if you're going to trumpet "Alternative" "traditional" or "holistic" medicine this way, I sort of expect some shred of evidence. (And no, aphorisms from the Tao Te Ching don't count.)
I lived in Hong Kong for several years, and let me tell you nothing about the traditional medicine over there says "aware of the cellular chemistry of oxygen resumption" to me.
Re:This was discovered in the US? (Score:5, Insightful)
Yes, actually, they are good American names.
Thank you (Score:1, Insightful)
It's the brain we worry about, not the heart (Score:3, Insightful)
It's the brain that's exquisitely sensitive to oxygen deprivation. That 5-minute window refers to irreversible brain damage that begins to occur after ischemia, not heart damage. It's also well known that brain tissue releases toxic metabolites after oxygen deprivation doing damage above and beyond what the lack of oxygen itself did. There are a number of therapies aimed at reversing or blocking this phenomenon, but none have been successful yet.
The intervention that has been shown to be most effective in changing survival outcome once someone's heart has stopped beating is good quality CPR as soon as possible. Most of these other innovations like cooling have only a minimal effect changing a dismal outcome to a not-quite-as-dismal-but-still-pretty-dismal outcome. Most of these intra and post resuscitative interventions only succeed in allowing a patient to linger in the ICU for a few extra days before finally dying.
Re:I'm continually amazed at (Score:3, Insightful)
However, yes, this would likely be useful in cryogenics. If it takes an hour for a cell to start to die, then you can afford to be much more gentle on tissue when thawing it, and therefore should be able to develop methods that are much less damaging. It should also increase the number of transplantable organs, as there'd be a far larger window of opportunity.
Re:Makes a little bit of sense. . . (Score:4, Insightful)
There is not a single 'ideal' compression to ventilation ratio. We know that for garden variety cardiac arrest due to V-Fib, ventilation in the first minute or so is probably almost meaningless. We also know that for hypoxic arrests (like a drowning) that ventilation is far more important. We also know that VFib makes up a greater percent of adult arrests and hypoxic arrests are more common in kids (all of whom get the same ratio.) Moreover the AHA made this decision knowing that they didn't even know the ideal ratio for the single most common type of arrest in the community (from VFib.) The 30:2 ratio was a way of keeping it simple that is not perfect for every kind of arrest, but is a reasonable compromise to try to deliver at least a reasonably acceptable type of CPR to all victims of arrest.
That is a good thing for lay-rescuers, but the AHA understands that people who are more highly trained and knowledgeable will guide their actions based on that knowledge. For example, if my partner grabbed his chest and collapsed, I would run to the phone, call 911. Return to him, check for a pulse, and if he had none, start wailing on his chest like a crazed weasel on crack. I would not even consider breaking compressions to give a breath till at least minutes had passed - or more trained people arrived and ACLS could be initiated. If however, I pulled him out of a pool, I would check for breathing and if none, give two full rescue breaths. Then check for a pulse, if none, start CPR with probably about a 15-20:2 ratio. I would stop for a moment at 1 minute. If he had a pulse, I would continue breathing for him a full minute or two before I ran to the phone. If he had no pulse, I would give two last breaths and run for the phone.
Those are drastically different methods that I chose knowing that they would give him the best chance in either situation. But if you try to teach lay-rescuers that, you will get blank stares and some shitty-assed CPR. So it is better to make things as simple as possible and make them so at least everyone gets 'reasonable' CPR.
Nick
Some facts to back up your opinion please? (Score:3, Insightful)
In that case, I urge you too look at any country in Europe that has this socialized healthcare you detest so much. Europeans are much more healthy and spend an order of magnitude less on healthcare than USians.
Now it is time to stick your head in the sand again...
Re:Some facts to back up your opinion please? (Score:3, Insightful)
Still I'm not convinced.
Where economic incentives do help with a market-based health insurance system is when employers have to pay for health insurance (as it is in most cases of full-time employment in the US). I suspect that the most important component of your lifestyle is what you do at work. By forcing employers to pay for health insurance, you provide an incentive for employers to provide a healthier environment for their employees since that means lower insurance premiums. Results of this that I've seen are: company cafeterias with a greater emphasis on also providing healthy food, on-site exercise centers, and improved emphasis on ergonomics and safety.
I also think that Europe's social, and physical structure works better for keeping people healthy: less relocations and more vacation mean less stress and more contact to friends and family, denser cities and better public transportation means more exercise, less wealth means less excessive eating. I don't believe that socialized healthcare is the primary factor in the health gap between the US and Europe.
In addition socialized healthcare has negative consequences which I have had to directly bear. My old doctor closed his practice because he couldn't earn enough to support himself and his family. My new doctor is great; I'm really happy with him, but the appointments are very short -- he's obviously over-worked. It's problems like this and others that have brought me to opt out of the German socialized healthcare system.
P.S. In Germany you pay between 12-15% of your salary for socialized health care. I'm not going to compare that to the US, since I don't actually know the percents in the US. I'm just putting that out there for anybody who does know the US number and wants to compare.