Trauma patients arriving at an emergency room here after sustaining a gunshot or knife wound may find themselves enrolled in a startling medical experiment.
Surgeons will drain their blood and replace it with freezing saltwater. Without heartbeat and brain activity, the patients will be clinically dead.
And then the surgeons will try to save their lives.
Researchers at the University of Pittsburgh Medical Center have begun a clinical trial that pushes the boundaries of conventional surgery — and, some say, medical ethics.
By inducing hypothermia and slowing metabolism in dying patients, doctors hope to buy valuable time in which to mend the victims’ wounds.
But scientists have never tried anything like this in humans, and the unconscious patients will not be able to consent to the procedure. Indeed, the medical center has been providing free bracelets to be worn by skittish citizens here who do not want to participate should they somehow wind up in the E.R.
“This is ‘Star Wars’ stuff,” said Dr. Thomas M. Scalea, a trauma specialist at the University of Maryland. “If you told people we would be doing this a few years ago, they’d tell you to stop smoking whatever you’re smoking, because you’ve clearly lost your mind.” (...)
The experiment officially began in April and the surgeons predict they will see about one qualifying patient a month.
It may take a couple of years to complete the study. Citing the preliminary nature of the research, Dr. Tisherman declined to say whether he and his colleagues had already operated on a patient.
Each time they do, they will be stepping into a scientific void. Ethicists say it’s reasonable to presume most people would want to undergo the experimental procedure when the alternative is almost certain death. But no one can be sure of the outcome.
“If this works, what they’ve done is suspended people when they are dead and then brought them back to life,” said Dr. Arthur L. Caplan, a medical ethicist at New York University. “There’s a grave risk that they won’t bring the person back to cognitive life but in a vegetative state.”
But researchers at a number of institutions say they have perfected the technique, known as Emergency Preservation and Resuscitation, or E.P.R., in experimental surgeries on hundreds of dogs and pigs over the last decade.
As many as 90 percent of the animals have survived in recent studies, most without discernible cognitive impairment — after the procedure, the dogs and pigs remembered old tricks and were able to learn new ones.
“From a scientific standpoint, we now know the nuts and bolts and that it works,” said Dr. Hasan B. Alam, chief of general surgery at the University of Michigan Medical Center, who has helped perfect the technique in pigs.
“It’s a little unsettling if you think of all the what ifs, but it’s the same every time you push into new frontiers,” he added. “You have to look at risk and balance it against benefits."
Surgeons will drain their blood and replace it with freezing saltwater. Without heartbeat and brain activity, the patients will be clinically dead.And then the surgeons will try to save their lives.
Researchers at the University of Pittsburgh Medical Center have begun a clinical trial that pushes the boundaries of conventional surgery — and, some say, medical ethics.
By inducing hypothermia and slowing metabolism in dying patients, doctors hope to buy valuable time in which to mend the victims’ wounds.
But scientists have never tried anything like this in humans, and the unconscious patients will not be able to consent to the procedure. Indeed, the medical center has been providing free bracelets to be worn by skittish citizens here who do not want to participate should they somehow wind up in the E.R.
“This is ‘Star Wars’ stuff,” said Dr. Thomas M. Scalea, a trauma specialist at the University of Maryland. “If you told people we would be doing this a few years ago, they’d tell you to stop smoking whatever you’re smoking, because you’ve clearly lost your mind.” (...)
The experiment officially began in April and the surgeons predict they will see about one qualifying patient a month.
It may take a couple of years to complete the study. Citing the preliminary nature of the research, Dr. Tisherman declined to say whether he and his colleagues had already operated on a patient.
Each time they do, they will be stepping into a scientific void. Ethicists say it’s reasonable to presume most people would want to undergo the experimental procedure when the alternative is almost certain death. But no one can be sure of the outcome.
“If this works, what they’ve done is suspended people when they are dead and then brought them back to life,” said Dr. Arthur L. Caplan, a medical ethicist at New York University. “There’s a grave risk that they won’t bring the person back to cognitive life but in a vegetative state.”
But researchers at a number of institutions say they have perfected the technique, known as Emergency Preservation and Resuscitation, or E.P.R., in experimental surgeries on hundreds of dogs and pigs over the last decade.
As many as 90 percent of the animals have survived in recent studies, most without discernible cognitive impairment — after the procedure, the dogs and pigs remembered old tricks and were able to learn new ones.
“From a scientific standpoint, we now know the nuts and bolts and that it works,” said Dr. Hasan B. Alam, chief of general surgery at the University of Michigan Medical Center, who has helped perfect the technique in pigs.
“It’s a little unsettling if you think of all the what ifs, but it’s the same every time you push into new frontiers,” he added. “You have to look at risk and balance it against benefits."
by Kate Murphy, NY Times | Read more:
Image: University of Pittsburgh Medical Center
