X-Message-Number: 30652
Date: Wed, 26 Mar 2008 23:12:22 -0400
From: 
Subject: CI's 81st Patient Benefited from SA Treatment (Part I)

The Cryonics Institutes 81st Patient
Greatly Benefited from Suspended Animation Treatment
(Part I)

   Melody Maxim wrote:

> As Ben Best knows, I think "nothing" would have better than  
> "something," in regard to the services provided to CI-81, by SA. As  
> a professional perfusionist, I believe the SA report and addendum  
> clearly indicate the over-pressurization of the patient, and a  
> failure to administer the proper medications.

    I repeat and will try to explain with greater clarity
why I believe that the evidence points strongly to the
conclusion that the Cryonics Institute's 81st patient was
greatly benefited -- not harmed -- by the transport
treatment he received from Suspended Animation, Inc.

   The patient required no standby because the moment of legal
death was determined by when life support was removed. This
allowed Suspended Animation to immediately begin cool-down
and CardioPulmonary Support (CPS). The patient was given
chest compressions from the time life support was removed to
the time his blood was washed-out and replaced with organ
preservation solution. The continuous chest compressions
circulated blood to the patient's tissues while his metabolic
rate was being reduced by the ice-bath cooling. Under these
conditions there should be no reperfusion injury when the
blood was washed-out.

   If the patient had only received the services of a funeral
director he would have only received a few chest compressions
to circulate heparin, cooling (with ice bags) would have been
far less efficient and there would have been no organ
preservation solution/blood replacement to preserve his
tissues. Any attempt by the funeral director to do a blood
washout without continuous CPS and ice-bath cooling would
have certainly resulted in reperfusion injury.

   By the use of an ice bath, CardioPulmonary Support (CPS)
and an ATP the patient was cooled to below 10oC in about half
the time such cooling could have been achieved by a funeral
director using ice bags. Moreover, CPS during the cooling period
meant that tissues could remain viable in a way that would
not have been possible without CPS. Administration of
citrate, epinephrine, streptokinase, vasopressin and antioxidants
in addition to the usual heparin eliminated clots (except
in the region of the cerebral hemorrhage), increased circulatory
capacity and reduced ischemic damage. Blood replacement with
organ preservation solution in a timely manner reduced the cold
ischemic damage the patient would have suffered during shipment
in ice to CI's Michigan funeral home where vitrification
perfusion was performed.

    It is commonly noted that metabolic rate is halved for every
10oC drop in temperature. But the reduction of lipid peroxidation
by cooling is greater than the reduction of metabolic rate, and
the greatest benefits occur for rapid cooling in the initial
stages. Experiments on gerbils indicate that a drop in temperature
from 37oC to 31oC nearly triples the amount of time that neurons
can tolerate ischemia [CRITICAL CARE MEDICINE; Takeda,Y;
31(1):255-260 (2003)]. Experiments with dogs that have been quickly
cooled with blood washout solution have shown that cooling from 30oC
to 10oC can extend the tolerable period of cardiac arrest without
neurological damage from 5 minutes to as much as 120 minutes
[CRITICAL CARE MEDICINE; Behringer,W; 31(5):1523-1531 (2003)].


(continuted in Part II)

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