UMC doc: ER care may 1 day put some in 'suspended' state
It sounds like pure science fiction - medically inducing a state called "suspended animation" in which a person is in between life and death. But the chief of Tucson's top-level trauma center wants to test it on humans as soon as next year.
The last-ditch lifesaving method of the future involves bringing patients' bodies down to hypothermic temperatures by infusing a refrigerator-cold solution into their veins.
Rhee defines suspended animation as, "when you are no longer alive but you are not dead."
The procedure, Rhee says, could make a serious difference in medicine, saving the lives of people who now have no hope of survival. He cited as an example a woman who recently came into the trauma center with a stab wound to the heart. She died, but Rhee said she would have been a candidate if the treatment were in place.
The Food and Drug Administration already has approved the technique for a human trial. The Army is expected to fund the feasibility phase, and Rhee is lobbying for funding for the full trial.
The treatment method would be used only in cases in which there's no other way to save the patient's life, Rhee stressed.
The technique, that he developed and perfected on research animals while in the military, would work like this: Surgeons inject a patient with a cold, potassium-rich solution used to preserve kidneys for transplant. That puts her in a state of suspended animation, which makes the heart stop and protect her brain.
The cold fluid takes the patient's body temperature down to severe hypothermia - about 50 degrees Fahrenheit - but it has been proven not to not have long-term effects on brain function, Rhee said. The method allows surgeons to work on repairing the patient's injuries for about 60 to 90 minutes while the body is in suspended animation, and the heart during this time is not beating. Medical researchers are trying to figure out ways to make that period last longer.
To that end, researchers are studying the trigger that slows the metabolism in hibernating animals. For example, certain types of squirrels can go from a heart rate of 200 when awake to a rate of four when hibernating.
Cooling the body is counter-intuitive care for trauma patients, who are normally kept warm to help blood clot. But mild cooling was one of several novel treatments used on U.S. Rep. Gabrielle Giffords, who was shot clear through the left side of her brain Jan. 8. The evening of the shooting, after Giffords had part of her skull removed, Rhee used a device on her that cools the skin.
"I believe that there is a thermostat that's broken after traumatic brain injury," he said. "Your metabolism is integrally related to your body temperature. And when your body temperature goes high with a fever you start cooking the brain. You don't have enough nutrients going to your brain."
Rhee said he realizes how implausible this all seems - even he thought it sounded a bit out there when a colleague first suggested it. But he has seen it work on animals, and he is certain it will work on humans.
"It sounds crazy right now," he said. But in 20 to 40 years paramedics could be trained to use a form of the technique to get the process started.
"If you were to go back 40 years from today, 1970, and I told you then that I could take someone's heart and stick it into someone else, that I could operate on your eyes with a laser and you won't need glasses, you would say I was drunk. And in 40 years those things are a reality.
"We have advanced ourselves so quickly in such a rapid timeframe that creating a state of suspended animation in the field, when a person has got devastating injuries, is not out of the realm of reality."