Reversing Death In The Emergency Room: Doctors Detail Frontline Of Resuscitation Science

on October 11 2013 3:46 PM
corpsefeet
New techniques in the emergency room could bring back more and more patients from the brink of death. Flickr via Creative Commons/jackaroid

Reversing death isn’t just Google’s latest venture; it’s the subject of serious medical research. Some doctors say that if we revise our accepted understanding of death, new techniques might allow us to bring patients back from a flat-lined state, making the final destination not so final.

This past Wednesday, the New York Academy of Sciences hosted emergency medicine experts Lance Becker and Sam Parnia, along with neurosurgeon Stephan Mayer to talk about the latest advances in bringing people back from the brink of oblivion.

Parnia, an assistant professor of medicine at the State University of New York at Stony Brook, studies ways to resuscitate the brains of people who approach or cross into the stage of clinical death. He emphasizes that death is a process, not a singular point in time. Even when your heart stops and your brain shuts down, the cells of your body -- which might be declared a corpse at that point -- are still living.

Or, to borrow some terminology from “The Princess Bride,” there’s a difference between “mostly dead” and “all dead.” And, as Miracle Max says in “The Princess Bride,” mostly dead is slightly alive.

One of the hot topics in resuscitation research is cold. The preserving principle behind cooling is the same one that drives people to freeze their pets or family members in cryogenic facilities. But patients don’t need to be put into deep freeze; just a shift of a few degrees below normal body temperature can buy doctors time to resuscitate someone with a stopped heart and an inactive brain.

At the NYAS lecture, Parnia related the story of a young Japanese woman who apparently killed herself in the Aokigahara forest at the base of Mt. Fuji, a popular destination for suicidal people. Hours later, she was found by a passerby and brought to the hospital, where her body temperature registered at 68 degrees Fahrenheit. After doctors worked to revive her for more than six hours, the girl returned to life. She’s even had a baby recently, according to Parnia.

“If we cool people down by a number of degrees Celsius ... we slow down the rate by which cells -- particularly brain cells -- are undergoing their own process of death, because we have to remember that cell death takes place through chemical steps,” Parnia told NPR interviewer Terry Gross back in February. “So, from our high school chemistry days we all know that chemical reactions need heat, and if you take away the heat, that slows down the chemical reaction."

There are other techniques that could bump up survival rates in hospitals as well: machines that perform sustained chest compressions, for example. Japanese emergency rooms make use of a technique called ECMO, which draws blood out of a deceased person’s body, infuses oxygen in it, and pumps it back in. ECMO keeps the oxygen supply to a “mostly dead” person’s brain closer to normal levels, giving doctors a better chance of restarting a patient’s heart if they manage to fix whatever underlying problem caused the person to die.

The fact that people can return to consciousness even after brains go offline obviously provokes the question of how long consciousness survives after death. But most doctors that study resuscitation are leery of getting into any spiritual or religious debates.

“I’m very comfortable to play doctor, but I’m not in the business of playing God,” Becker said at the NYAS symposium.