The next new thing doctors are trying to do to save our lives? Bring us that much closer to death.
Suspended animation is an experimental technique that could buy critically injured patients the crucial extra time needed for surgeons to save their lives. Dr. Peter Rhee, chief of Tucson, Arizona’s trauma center is one of several pioneers behind a growing push to graduate suspended animation from experimental vetting to common treatment. He’s getting there. The Food and Drug Administration has already approved his technique for human trials, and he has secured funding from the Army to conduct the feasibility phase. Dr. Rhee is currently lobbying for funds to conduct a full trial. If he’s successful human trials could begin as early as next year.
The idea is simple: slow a person’s metabolism to such a crawl that the process of dying from say, a gunshot wound, is held in check. Like an animal in hibernation breathing, heartbeat, brain function and general metabolic functions are slowed drastically. Talking to the Arizona Star Daily, Dr. Rhee called suspended animation “when you are no longer alive but you are not dead.”
What Dr. Rhee hopes to test on humans is a method he worked out for the past couple decades on pigs. Patients would be injected with a cold fluid to induce severe hypothermia. Clinically hypothermia is characterized by the drop of a person’s body temperature from its normal 98.6 degrees Fahrenheit (37 degrees Celcius) to lower than 95 degrees (35 C). Below 95, the heart, nervous system and other organs begin to fail. The strict range is indicative of a metabolic system with strict temperature requirements for proper function (death waits only a few degrees the other way as well). Dr. Rhee’s method involves injecting patients with a cold fluid that would bring the body’s temperature down to 50 degrees Fahrenheit (10 C). Sounds chilling, but when he induced the extreme hypothermia in pigs they came out just fine. Heart function, breathing, and brain function was completely normal.
By putting death on hold doctors are able to buy time, and for trauma patients every second counts. It is estimated that surgeons will be able to work on patients in suspended animation for 60 to 90 minutes, during which time the heart is not beating. Researchers are currently searching for ways to extend the suspended duration even further.
Clearly, cooling someone’s body to a point that their heart stops beating is a drastic measure. The aim is to use suspended animation only as a measure of last resort. Dr. Rhee mentioned a woman who had been stabbed in the heart and eventually died at Tucson’s trauma center. “It’s those kinds of people, where the injury takes a little bit more time to fix, you could take your time to do microsurgery on them because they are not bleeding to death,” he told the newspaper.
Dr. Rhee is no stranger to high-stakes medicine. The native South Korean was trained at the Uniformed Services University Medical School in Bethesda, Maryland. Following a fellowship in trauma and critical care at the University of Washington’s Harborview Medical Center he served in the US Navy as director of the University of South California’s Navy Trauma Training Center at Los Angeles County. He was then sent to Afghanistan where he was one of the first surgeons at Camp Rhino. Later he started the first surgical unit at Ramadi, Iraq.
His cool under fire was on display nationally as he performed surgery on US Representative Gabrielle Giffords after she was shot through the skull in the Tucson shootings this past January. His experience with induced hypothermia came into play the night of the shootings when Dr. Rhee removed part of the congresswoman’s skull. The wound had raised her body temperature and began “cooking the brain.” He used a device to cool Rep. Giffords’ skin.
Dr. Rhee joins a growing number of clinicians and scientists who are trying to make suspended animation part of the trauma surgeon’s toolkit. Hasan Alam of Harvard Medical School has an induced hypothermia protocol of his own that he is trying to get to clinical trial. And Mark Roth at the Fred Hutchinson Cancer Research Center in Seattle takes a metabolic approach, decreasing the need for oxygen by introducing a molecule that binds oxygen receptors and thus prevents oxygen from doing so. Inspired by animal hibernation, Dr. Roth’s team has successfully put yeast, roundworms, fruit flies, frogs, and zebrafish into a state of suspended animation for up to 24 hours, simply by blocking oxygen. The metabolism-slowing molecule is now in Phase II clinical trials.
The Russian method of resuscitation dates back to 1803. It involves covering the patient with snow in hopes to revive circulation. More recently, variants of induced hypothermia have been used for years to minimize damage to the brain following brain trauma or during brain surgery. So maybe, when suspended animation finally does become common practice in trauma surgery rooms, we won’t say it’s “like science fiction.” The idea belonged to science in the first place, but turned out to be harder to pull off in an operating room than a movie set.