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Selects: How Therapeutic Hypothermia Works · Stuff You Should Know

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Speaker 1: M Hey everybody, it's Josh and for this week's select,
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Speaker 1: I've chosen our two thousand fifteen episode on therapeutic hypothermia.
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Speaker 1: It sounds weird and boring and it's a really super
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Speaker 1: science EPP. But sometimes sometimes those can be the best ones.
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Speaker 1: This topic is super interesting. It's a look at how
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Speaker 1: science can stave off death and hopefully it's the direction
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Speaker 1: that modern medicine is heading. Plus, if you get bored,
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Speaker 1: you can thrill the hearing us. Try to say cellular
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Speaker 1: level here or there. It's hilarious. Enjoy. I command you.
0:37
Speaker 1: Welcome to Stuff you Should Know, a production of I
0:40
Speaker 1: Heart Radio. Hey, and welcome to the podcast. I'm Josh Clark.
0:49
Speaker 1: There's Charles W. Eager Beaver, Chuckers Bryant ready to get
0:54
Speaker 1: its therapeutic hypothermia on. Yeah, baby, I'm chilling. Yeah, moving
0:59
Speaker 1: at a glacial paste today, right, I am um, I'm
1:03
Speaker 1: sorry for that. That was actually a poke at the
1:06
Speaker 1: author of this article. Yeah, that's uh. That stood out
1:10
Speaker 1: to me as well. I'm not telling you Jerry's over
1:13
Speaker 1: there and stuff you should know. No, I'm done. Um. Yeah,
1:17
Speaker 1: we were goofing off about this article and how stuff works.
1:20
Speaker 1: That there were way too many cold puns for my liking.
1:24
Speaker 1: There was a lot of puns, you know, a lot
1:28
Speaker 1: lots of them. Yeah, this article stinks of punt it reeks.
1:33
Speaker 1: So how you doing, man, how you feeling? I'm good? Uh,
1:37
Speaker 1: it seems there's a sickness going around the office. Yeah,
1:40
Speaker 1: which I thought we knew here in two thousand and
1:43
Speaker 1: fifteen that if you're sick, you don't come into work,
1:46
Speaker 1: especially when you have a liberal telecommune policy right like
1:48
Speaker 1: we do. I realized, Um, I realized that people need
1:53
Speaker 1: to come in and shoot video and recording all that.
1:55
Speaker 1: But come in, you do that, and you leave, and
1:58
Speaker 1: you wear like a plague doctor's mask the whole time
2:01
Speaker 1: you're here too. Yeah. I mean, I have a biohazard
2:03
Speaker 1: suit at my desk, but has a RiPP in it.
2:06
Speaker 1: Anyone can wear it, has a ripping. It's very small
2:10
Speaker 1: rental and cleaning fee. You're going to take a blood
2:13
Speaker 1: sample of mine wearing that thing. And it occurred to
2:17
Speaker 1: me as you were about to put it on, like
2:19
Speaker 1: I don't know where that thing has been, Like, that's
2:20
Speaker 1: a real biohazard suit and Chuck's going to use it
2:24
Speaker 1: to open my skin. Yeah, this sounds very odd. Um,
2:28
Speaker 1: we don't just do this in the office. We did
2:31
Speaker 1: our blood Types episode live here in Atlanta, and we
2:33
Speaker 1: actually took Josh's blood type on stage because you didn't
2:37
Speaker 1: know it. No, I when we recorded the version in
2:41
Speaker 1: the studio, I genuinely did not know it. Yeah, so
2:44
Speaker 1: I took your blood on stage. You trusted me. I
2:46
Speaker 1: did not wear the contaminated suit. No, you. You just
2:49
Speaker 1: used your dirty hands with no like rubber gloves or anything.
2:53
Speaker 1: Look at you. You're fine ish and you know your
2:56
Speaker 1: blood type now, which was a positive like Jarius, So
3:03
Speaker 1: we should release that whole live show. Is a just
3:06
Speaker 1: a special yeah little bonus. Yeah bonus. That was the
3:09
Speaker 1: word I was looking for. There's something special about it.
3:11
Speaker 1: It's just a bonus. That was special. Yeah, it's a
3:14
Speaker 1: good idea. Look for that soon people. So, uh, today, Chuck,
3:19
Speaker 1: we're talking about therapeutic hypothermia and I am very excited
3:23
Speaker 1: about this. This is my idea of this article. Yeah, Um,
3:27
Speaker 1: it's pretty neat. I don't remember. I guess I first
3:29
Speaker 1: heard of it from that Mosaic article that we both
3:31
Speaker 1: read to the big sleep awesome article. And uh, if
3:35
Speaker 1: you haven't figured out by now we have started to
3:38
Speaker 1: on the podcast page for each episode, put related links
3:42
Speaker 1: on there on our site stuff you should know dot com,
3:45
Speaker 1: so that articles on there. There's a bunch of other
3:47
Speaker 1: stuff on there too that will cover UM. But be
3:50
Speaker 1: sure to check out that mosaic article. It's very neat
3:53
Speaker 1: um and that article first introduced me to the concept
3:57
Speaker 1: of therapeutic hypothermia or medically induced hypothermia as another another
4:03
Speaker 1: term for it. I don't prefer target targeted temperature management.
4:07
Speaker 1: That sounds yeah corporate, Yeah, very corporate. You know the
4:13
Speaker 1: HMO term for it, like we'll we'll call it this
4:15
Speaker 1: because it'll less than the likelihood that we'll get sued
4:17
Speaker 1: or something exactly. Yes, yeah, I agree. But it's been
4:21
Speaker 1: around for a while, and the the idea that exposing
4:24
Speaker 1: people to lower temperatures to allow for better medical interventions,
4:29
Speaker 1: which is the whole basis of therapeutic hypothermia UM, has
4:33
Speaker 1: been around at least since the Napoleonic Wars. Yeah, it's
4:37
Speaker 1: pretty neat. I was interested to find that out. They
4:39
Speaker 1: noticed way back when in the eighteen hundreds early eighteen hundreds,
4:44
Speaker 1: uh that troops in battlefield trauma, wounded soldiers would the
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Speaker 1: ones who were not kept warm and cozy by the
4:51
Speaker 1: fire or in their tents, right, they're just left out
4:53
Speaker 1: on the battlefield and the coals. Yeah, they actually fared better.
4:56
Speaker 1: And they were like, wait a minute, is uh And
4:59
Speaker 1: of course they had no idea at the time what
5:00
Speaker 1: was going on. No, they're like, did you notice that? Yes,
5:02
Speaker 1: I did notice that the heart well back to our brandy, Yeah,
5:06
Speaker 1: pretty much. But they did notice that the ones who
5:09
Speaker 1: were warm did a lot worse than the ones that
5:11
Speaker 1: were left out in the cold, which is super interesting. Yeah,
5:13
Speaker 1: But the the real investigation into what was going on
5:17
Speaker 1: there didn't start until the thirties with a guy named
5:20
Speaker 1: Dr temple Faye, and he was actually the first guy
5:23
Speaker 1: to write about using therapeutic hypothermia. I think in n
5:29
Speaker 1: was the first paper about it. But he was using
5:31
Speaker 1: it for a full decade or so before then, basically
5:34
Speaker 1: putting his patients in ice baths, opening the windows to
5:37
Speaker 1: their room during the winter, and um, just basically using
5:41
Speaker 1: any means he could to lower the temperature for I
5:45
Speaker 1: think I think he had he was using in a
5:47
Speaker 1: traumatic brain injury patients. Yeah, and I'm sure he did
5:50
Speaker 1: a lot of explaining along the way to family members
5:53
Speaker 1: that were like, hey, can you close the window and
5:55
Speaker 1: warm up my husband here? And that. He was like,
5:58
Speaker 1: all right, you wanted to I think back then too,
6:01
Speaker 1: he was like, it's the thirties and this guy is
6:03
Speaker 1: a traumatic brain injury. Really, there's nothing I can do
6:06
Speaker 1: to make it worse, the prospects worse, So why don't
6:10
Speaker 1: you just lighten up their family member? So there was
6:13
Speaker 1: another pioneer in the fifties named Dr Peter safar Um
6:17
Speaker 1: s A f A R. And he actually began experimenting
6:21
Speaker 1: around with this in the e er as well, trying
6:24
Speaker 1: to reduce tissue injury uh and brain image from a
6:27
Speaker 1: lack of blood flow. Uh. And this was mainly at
6:30
Speaker 1: the time in like stroke patients, cardiac arrest patients and
6:34
Speaker 1: what we'll talk more about it. There's all sorts of
6:36
Speaker 1: well not all sorts. There are several uses like cases
6:40
Speaker 1: where you would want to use this and UM ranging
6:44
Speaker 1: from cardiac arrest to like a gunshot wound to I think,
6:49
Speaker 1: what is the infant situation? Come again, it is called chuck.
6:54
Speaker 1: It's a type of encephalofy were ummic encephalofy. Yeah, where
6:59
Speaker 1: your natal basically the blood flow the lack of blood
7:02
Speaker 1: flow to the brains cut off for whatever reason, like
7:05
Speaker 1: maybe the umbilical cord gets rappidly on the baby's neck
7:07
Speaker 1: or what have you. Um, it leads to a swelling
7:12
Speaker 1: in the brain, and they started using it to medical
7:17
Speaker 1: the hypothermia to treat that. That's right, And that was
7:20
Speaker 1: in the fifties, right, Yeah, the fifties and sixties is
7:23
Speaker 1: when Dr Safar was doing his work. So this this
7:26
Speaker 1: is all kind of going on on the side and
7:29
Speaker 1: um experiments into hypothermia had kind of a bad name
7:35
Speaker 1: thanks to the Nazis, and a little bit also the
7:38
Speaker 1: Japanese and World War Two. But the Nazis, especially at
7:42
Speaker 1: Dock how the concentration camp or the death camp there
7:46
Speaker 1: um experimented using unwilling human subjects. Uh, they experimented on
7:53
Speaker 1: the effects of hypothermia in people's bodies. They did all
7:56
Speaker 1: manner of horrible, grizzly, gruesome stuff for they recorded the
8:01
Speaker 1: data and there was a long debate over the years
8:04
Speaker 1: over whether that data could be ethically used. And on
8:07
Speaker 1: one hand, people were saying, no, it's the Nazis. They
8:11
Speaker 1: used unwilling subjects. Is it amounted to torture in the
8:15
Speaker 1: name of science, and I just used air air quotes, right.
8:19
Speaker 1: And then other people said, well, wait a minute, these
8:21
Speaker 1: people died, um whether and we're whether they wanted to
8:26
Speaker 1: or not. They were made to be these test subjects
8:28
Speaker 1: and they gave their lives. We can honor them at
8:30
Speaker 1: least by using the data that was cold from it. Well,
8:33
Speaker 1: once they really dug into the data that the Nazis
8:36
Speaker 1: had accumulated, it was just like rank amateurs performing scientific experiments.
8:41
Speaker 1: They followed like almost no protocol. They did terrible record
8:46
Speaker 1: keeping of descriptions of subjects and things like that. So um,
8:51
Speaker 1: it's almost like you just have to toss it out
8:53
Speaker 1: because you just can't trust it scientifically the data. But
8:58
Speaker 1: but the idea that people were exposed forcibly to hypothermic
9:03
Speaker 1: conditions kind of gave hypothermia a bad name. So these
9:06
Speaker 1: guys experimenting with the stuff, it was fringe science for
9:10
Speaker 1: a while. Yeah, and then it started to come into
9:12
Speaker 1: the mainstream and then everybody said, well, wait a minute,
9:15
Speaker 1: hypothermia has all these bad side effects. Let's just table
9:18
Speaker 1: it for now. Yeah. In the in the fifties to
9:21
Speaker 1: NASA was doing a lot of work during the Space
9:23
Speaker 1: Race because the idea was and this is really sort
9:26
Speaker 1: of two parts. There's the the modern day uh cooling
9:32
Speaker 1: like that's not freezing somebody basically, and then we also
9:36
Speaker 1: have what's called suspended animation, which we'll get too later.
9:38
Speaker 1: Those are totally different things, totally different things, but they
9:41
Speaker 1: follow the same process initially, right yeah, um, well sort of,
9:44
Speaker 1: I mean the methods are different, but the same idea
9:47
Speaker 1: basically is to slow the body down, sown the heart rate,
9:49
Speaker 1: slow down everything, your metabolism. Yeah. Um. But NASA was
9:53
Speaker 1: doing this because they put a lot of money into
9:56
Speaker 1: it because they thought two things. One you could protect
9:58
Speaker 1: astronauts from cosmic rays and the other is basically straight
10:03
Speaker 1: up alien like we can freeze people on long journeys
10:08
Speaker 1: into space and then unfreezing when they get there, which
10:11
Speaker 1: is not just alien. That's a bunch of sci fi movies.
10:15
Speaker 1: But there was a doctor named James Lovelock back in
10:19
Speaker 1: the day who was um freezing hamsters until they froze
10:23
Speaker 1: and then basically until he couldn't hear heartbeat frozen, yeah,
10:27
Speaker 1: they were clinically dead. Yeah, and then they would he
10:29
Speaker 1: would put a little, uh, a little hot teaspoon against
10:32
Speaker 1: their belly and warm him back up, and he found
10:35
Speaker 1: that they were actually okay, and he was able to
10:37
Speaker 1: revive them some of them. Well sure, yeah, I'm sure
10:40
Speaker 1: there were losses along them, but I mean even one
10:42
Speaker 1: coming back to life and seeming normal again, it is
10:47
Speaker 1: pretty significant. It's a significant finding, Yeah, because basically the
10:51
Speaker 1: idea was planted all of a sudden that hypothermia can
10:54
Speaker 1: kill you or it can preserve you and keep you
10:58
Speaker 1: from dying in an extreme situation, right, which is kind
11:02
Speaker 1: of counterintuitive. Like you think of people who undergo hypothermia
11:07
Speaker 1: or you know, being exposed to extremely cold temperatures, they're dead.
11:10
Speaker 1: I mean, we've all seen the shining, we know the end. Yeah,
11:14
Speaker 1: But apparently there's a rule of thumb among the er
11:17
Speaker 1: physicians and staff that there's no such thing as a
11:21
Speaker 1: cold dead body. I thought it was measured twice cut once.
11:26
Speaker 1: It's a little different. That's for the surgeons. Um, No,
11:30
Speaker 1: there's no such thing as a as a cold dead body.
11:33
Speaker 1: You're only dead when you're warm and dead, right, Because well,
11:37
Speaker 1: there's been some some cases throughout the years. The one
11:40
Speaker 1: that spectacular one. Yeah, this lady um was she with
11:44
Speaker 1: Norwegian on a boggenhorn. Um, I don't even know what
11:48
Speaker 1: that is. It's not an oom out, it's a single
11:50
Speaker 1: circle above that A. That's a it's a very Norwegian. Yeah,
11:55
Speaker 1: death metal band name totally. Uh So she was skiing
11:59
Speaker 1: and um, actually I think she was Swedish, but she
12:02
Speaker 1: was on holiday skiing in Norway. Um fell headfirst into
12:06
Speaker 1: a frozen stream and was trapped under ice, submerged for
12:10
Speaker 1: eighty minutes, stopped breathing, heart stopped. Yeah. I mean she
12:16
Speaker 1: was well known. She didn't drown. They thought she drowned
12:19
Speaker 1: until they reheated her. Ten days they reheated her and
12:25
Speaker 1: she was fine, Like weeks and months later she fully recovered.
12:29
Speaker 1: And basically, if you're underwater warm water, you have a
12:33
Speaker 1: few minutes at most. But what they discovered was if
12:36
Speaker 1: you actually go into hypothermia, it can preserve your body. Um,
12:41
Speaker 1: which was amazing and a big breakthrough into like, hey,
12:45
Speaker 1: maybe we can use this right. Yeah, she was one
12:47
Speaker 1: of a few a handful of people and we'll talk
12:50
Speaker 1: about some others too, but um, that what researchers into
12:55
Speaker 1: hypothermia I've learned and why they figured out that they're
12:58
Speaker 1: you're not cold and dead you're just warm. And debt
13:01
Speaker 1: is that it's not the the the addition of cold
13:07
Speaker 1: or the exposure to cold that kills you. It's warming
13:10
Speaker 1: back up in the wrong way too rapidly under the
13:14
Speaker 1: wrong circumstances stances that that's what can kill you. Yeah,
13:19
Speaker 1: it seems like it's a very fine line between well,
13:22
Speaker 1: we'll talk about the process, but you have to do
13:24
Speaker 1: it just right on the cooling side and the warming
13:28
Speaker 1: side if you want to be successful right exactly. You know,
13:31
Speaker 1: it's they haven't quite figured it all out yet. This
13:33
Speaker 1: is in the very uh nascent stages. Still. It is
13:36
Speaker 1: ridiculously primitive and and to the point where it's kind
13:40
Speaker 1: of like if you're a doctor experimenting with this, you
13:42
Speaker 1: you would be like, there's a d chance that your
13:47
Speaker 1: dad is going to die under normal circumstances. We have
13:52
Speaker 1: this one radical technique we can try that might help.
13:55
Speaker 1: Can we try this? And that that that whether they
14:00
Speaker 1: had lives or dies after being given medical hypothermia, he's
14:04
Speaker 1: still going to end up as like the subject of
14:06
Speaker 1: a major paper that would be written, because that's where
14:10
Speaker 1: it's at right now. Yeah, And I read one doctor
14:12
Speaker 1: said that they they think they pretty much know, it's
14:15
Speaker 1: super possible and we'll work, he said, But it's the
14:18
Speaker 1: the doing of it that's just really really hard. Exactly. Yeah,
14:21
Speaker 1: I mean like it makes a complete sense intuitively, we
14:25
Speaker 1: understand like what it's doing. It's just yeah, the fine tuning,
14:28
Speaker 1: the nuance behind it that it's still kind of mysterious.
14:32
Speaker 1: The most brilliant doctors say, it's just really hard. He said,
14:35
Speaker 1: it's really dog gone hard to do. It kind of
14:37
Speaker 1: makes you go, yeah, you know, is that the quote?
14:41
Speaker 1: He know, his quote was, it's really dog gone hard.
14:43
Speaker 1: And then my quote was, but we'll talk about medical
14:48
Speaker 1: hypothermia and what it is specifically, uh, in just a
14:53
Speaker 1: minu alright, so therapeutic hypothermia. Hypothermia is basically when you
15:17
Speaker 1: lower the body temperature for various reasons to keep it alive.
15:24
Speaker 1: And right now, what they're mainly doing now, this isn't
15:27
Speaker 1: the second wave, which is freezing somebody. This is just
15:31
Speaker 1: cooling a body before and after surgery to help them
15:36
Speaker 1: increase their chances of survival. Basically, right, your your body. Um,
15:41
Speaker 1: and they're doing that now on this side, they're just
15:45
Speaker 1: not doing the other quite yet on humans. Yes, um,
15:48
Speaker 1: so under normal circumstances, your body maintains a normal core
15:52
Speaker 1: body temperature, normative temperature because what it's called, right, and um,
15:57
Speaker 1: that's somewhere between like nineties in nine point six degrees
16:02
Speaker 1: is a normal human core body temperature. And all of
16:06
Speaker 1: this is and dude, do you remember and like when
16:08
Speaker 1: I went on that crazy, weird metaphysical tangent and does
16:11
Speaker 1: the body replace itself? Somebody wrote in and said, check
16:16
Speaker 1: this article out, like here's a really great explanation of
16:20
Speaker 1: why things live, where life comes from. And it was this, um,
16:24
Speaker 1: this idea, it's a physics based idea of life and evolution.
16:29
Speaker 1: And it says that because of entropy, because of one
16:33
Speaker 1: of the laws of thermodynamics, that atoms will arrange themselves
16:36
Speaker 1: in a way that they can take in energy and
16:39
Speaker 1: dissipate heat in a really efficient manner. And so of
16:43
Speaker 1: course they're gonna atoms are eventually going to arrange themselves
16:46
Speaker 1: into life. It just makes total sense. Right, So, being
16:50
Speaker 1: living things like we are, we take in energy and
16:54
Speaker 1: we dissipate heat, and that's what forms our core body temperature. Right.
16:58
Speaker 1: With therapeutic hype of thermia, what you're doing is lowering
17:03
Speaker 1: the metabolic rate through the addition of cold, and so
17:08
Speaker 1: we put out less heat, and by doing that, we're
17:12
Speaker 1: also lowering our energy demand, so that that that little
17:17
Speaker 1: engine that's going all the time and our cells and
17:19
Speaker 1: our body in general gets slowed down. And it's not
17:23
Speaker 1: altered in any way except for the speed and the
17:26
Speaker 1: energy consumption. It's just slowed down. It's doing everything slower.
17:30
Speaker 1: And you can do that simply by lowering the temperature
17:34
Speaker 1: of the person. Yeah, and it's it's not just lower,
17:37
Speaker 1: it's um it doesn't need to be faster. Does that
17:42
Speaker 1: make sense, Like the heart beat slower because it doesn't
17:45
Speaker 1: need to beat any faster, not like your body is struggling.
17:48
Speaker 1: Your body is still doing fine. It's just reducing the
17:50
Speaker 1: demand for stuff like blood flow and neurotransmitter action and
17:54
Speaker 1: stuff like that exactly. And ultimately, what your heart does
17:58
Speaker 1: is pumps blood. And what your blood has this, among
18:00
Speaker 1: other things, oxygen, and your cells need oxygen to carry
18:04
Speaker 1: out these metabolic processes to burn energy, right, So if
18:08
Speaker 1: they need less, then your heart doesn't have to beat
18:11
Speaker 1: as much. It's like you said, it's just the normal processes,
18:14
Speaker 1: but on a much slower scale. Pretty awesome stuff. It is,
18:19
Speaker 1: and it's just through the application of colder temperatures. Oh yeah,
18:22
Speaker 1: and in this case UM, and we'll get to how
18:25
Speaker 1: to do it. But in this case you're not I
18:26
Speaker 1: mean you're literally cooling the body with like ice packs
18:29
Speaker 1: and cold blankets and stuff like that pre surgery and
18:33
Speaker 1: post surgery. It's not the suspended animation one that we'll
18:36
Speaker 1: get to when they're actually like pumping frozen saline through
18:40
Speaker 1: your pains. No, there are, but there are some UM
18:43
Speaker 1: techniques for medically induced hypothermia that do put in like
18:49
Speaker 1: chilled saline to chill your body down very quickly. But
18:53
Speaker 1: it's not like replacing your blood. Yeah yeah, yeah, I
18:56
Speaker 1: hear you. So there's a couple of applications at this point.
19:00
Speaker 1: End the cases are either involved intervention or prevention, and
19:04
Speaker 1: intervention is when they're trying to prevent further damage from
19:08
Speaker 1: an incident like a stroke or cardiac arrest or sort
19:12
Speaker 1: of the two main ones UM and then preventative wise,
19:17
Speaker 1: it's to extend operating time because back in the day
19:20
Speaker 1: you could not operate on UM. Well, back in the
19:24
Speaker 1: day you couldn't stop the heart to operate on it. No,
19:27
Speaker 1: which was I do remember we did like this day
19:30
Speaker 1: in history about the first guy to ever do open
19:32
Speaker 1: heart centuries of Black surgeon in Chicago the early twentieth century,
19:37
Speaker 1: I think, and he did an emergency open heart surgery
19:41
Speaker 1: with a beating heart. That guy was totally awesome, champion. UM.
19:47
Speaker 1: This was the case for a very long time, and
19:49
Speaker 1: you couldn't stop the heart. They finally invented a machine
19:54
Speaker 1: UM that basically does the work of the heart and
19:57
Speaker 1: the lungs, called the Heart Lung machine. Exactly where you're
20:01
Speaker 1: transferring blood through this machine and UM, it's removing c
20:05
Speaker 1: O two, it's adding oxygen, and it's pumping it back
20:08
Speaker 1: into the body while the heart and lungs are stopped.
20:12
Speaker 1: Revolutionized open heart surgery. There's problems with it. One of
20:16
Speaker 1: the problems is um when the blood comes back in
20:19
Speaker 1: the body, since it's been through this machine, it may
20:22
Speaker 1: have picked up some sort of foreign in bacteria, and
20:27
Speaker 1: the immune system sometimes mounts an attack on the blood.
20:30
Speaker 1: So this this machine poses its own problems. And alternatively,
20:34
Speaker 1: an alternative method for stopping the heart or slowing the
20:38
Speaker 1: heart is to use medically induced hypothermia. So that's an intervention, no,
20:43
Speaker 1: a prevention preventative use of medically induced hypothermia. But intervention
20:49
Speaker 1: is another way, like you said, and it can have
20:51
Speaker 1: to do a stroke or heart attacks or cardiac arrest. Right,
20:55
Speaker 1: aren't those two different things? I think so technically, but
20:59
Speaker 1: in some sort of cessation of the heart pumping blood.
21:02
Speaker 1: And the big problem with that it doesn't really matter
21:05
Speaker 1: whether your hand is getting blood for a while. The
21:07
Speaker 1: big problem that comes from a heart attack is your
21:10
Speaker 1: brain not getting blood for a while. Right, So here's
21:15
Speaker 1: what happens when blood stops flowing into your brain. Right,
21:19
Speaker 1: And we we covered this somehow in the How Dying
21:22
Speaker 1: Works episode. Yeah, the dying process. Okay, because it's not
21:26
Speaker 1: a it's not a black and white thing. Uh, you're
21:29
Speaker 1: not alive and then you're dead. It's comes in many
21:32
Speaker 1: many stages. And we talked about the stages of death. Yeah,
21:35
Speaker 1: so there's when what they've discovered is that, yeah, you're
21:39
Speaker 1: not like I'm alive and now I'm dead. Is what
21:42
Speaker 1: we covered in the How Dying Works episode? Right, Like
21:44
Speaker 1: dying in your sleep? I mentioned that the other day.
21:47
Speaker 1: How like nobody dies in their sleep. That's just a
21:49
Speaker 1: nice thing. That's a nice way to say they died
21:51
Speaker 1: in their bed. Yes, overnight, overnight, Yeah, exactly. Um so, yeah,
21:57
Speaker 1: there's with medically induced hypothermia, they've been able to extend
22:01
Speaker 1: that that time between when you appear to be dead
22:04
Speaker 1: and when you're actually dead, and by extending that time
22:07
Speaker 1: they can intervene UM better. And Yeah, even a little
22:13
Speaker 1: bit of time can go a long way. So one
22:15
Speaker 1: of the one of the things that medically induced hypothermia
22:19
Speaker 1: has been shown to really help is what's called return
22:21
Speaker 1: of spontaneous circulation after uh, you have a heart attack.
22:27
Speaker 1: The problem is is your heart and lungs can your
22:29
Speaker 1: cardio pulmonary system can start working again, but you might
22:33
Speaker 1: not regain consciousness. And in that case, that's a sign
22:37
Speaker 1: that your brain may be in trouble, your cognitive function,
22:40
Speaker 1: you may be suffering brain damage at that moment. Yeah,
22:43
Speaker 1: And isn't the stat one and ten cardiac arrest outside
22:47
Speaker 1: of a hospital has a like goes on to live
22:50
Speaker 1: like a without brain damage. Yeah, ten, only because you
22:54
Speaker 1: have a very small window and that window is usually
22:57
Speaker 1: longer than it takes to get to the hospital. Right,
22:59
Speaker 1: So if they bring you in and you are showing
23:01
Speaker 1: signs of um r OSC without return to consciousness, too um.
23:06
Speaker 1: They may induce medical medical hypothermia. And the reason why
23:10
Speaker 1: is the heart pumps blood, and blood contains things including
23:14
Speaker 1: oxygen right um. And one of the organs that uses
23:19
Speaker 1: probably the most oxygen of all, is the brain, and
23:22
Speaker 1: the brain uses its oxygen to um burn energy. Basically,
23:26
Speaker 1: it uses it to oxidize glucose. And when it does that,
23:30
Speaker 1: the reason it does is because you're neurons, your little
23:33
Speaker 1: neural cells that fire. The way they fire is because
23:36
Speaker 1: their chemical battery, their chemical battery with the stored potential charge,
23:41
Speaker 1: and they do that by keeping a lower concentration of
23:44
Speaker 1: electrolytes inside the cell than outside. So this difference creates
23:49
Speaker 1: the electrical charge that your neurons used to fire. Right
23:52
Speaker 1: on normal circumstances, that's all well and good, but when
23:56
Speaker 1: they stop, when they stop getting oxygen, they can switch
24:00
Speaker 1: to anaerobic mode for a little while, so they're still
24:02
Speaker 1: burning energy, but they're like, you need to start breathing again,
24:05
Speaker 1: because this is not very efficient. It's like the like
24:08
Speaker 1: when the emergency lights go on exactly exactly. So um.
24:13
Speaker 1: As a byproduct of anaerobic um respiration, you get the
24:17
Speaker 1: stuff called lactic acid. Lactic acid in and of itself
24:20
Speaker 1: isn't bad, but it can build up. One of the
24:23
Speaker 1: other things that happens to when these um when this uh,
24:26
Speaker 1: when that runs out, is the difference between electrolytes inside.
24:31
Speaker 1: Now inside the cell stops like it, it evens out,
24:35
Speaker 1: and now all of a sudden you have things like calcium, potassium,
24:38
Speaker 1: sodium coming in and out of the cell as much
24:40
Speaker 1: as they please, and the cell is like, what is
24:42
Speaker 1: going on? This isn't good and releases its store of glutamate.
24:46
Speaker 1: And glutamate is a neurotransmitter that excites neurons, and again
24:52
Speaker 1: in very small amounts, totally fine, it's needed. But when
24:55
Speaker 1: a neuron just freaks out and dumps all that into
24:59
Speaker 1: a synapse, it sets off that neuron and all these
25:01
Speaker 1: other neurons and makes them go totally crazy, and it
25:04
Speaker 1: also um lowers their structural integrity. So all of a
25:09
Speaker 1: sudden you have neurons going nuts, dumping their contents everywhere,
25:12
Speaker 1: and then creating also free radicals, which are um atoms
25:16
Speaker 1: with unpaired electrons, and they run up against the cellular
25:19
Speaker 1: structure and the cell walls and start borrowing electrons from
25:23
Speaker 1: those atoms, and that weakens the structure even more so,
25:26
Speaker 1: even more stuff gets dumped out into the inter cellular matrix,
25:30
Speaker 1: and you have a problem. This is a really big
25:32
Speaker 1: problem in and of itself. Right, you're still with me, Okay,
25:36
Speaker 1: that's what happens when you stop getting blood flow. It's
25:39
Speaker 1: just as bad, if not worse, when you start getting
25:42
Speaker 1: blood flow again, because you have all these damaged cells.
25:45
Speaker 1: You have dead cells. And when you have dead cells
25:47
Speaker 1: that have dumped their contents, one of the roles that
25:50
Speaker 1: your white blood cells, your immune system plays is to
25:53
Speaker 1: come clean up dead cells because that's toxic stuff. That's
25:56
Speaker 1: bad stuff, and you need to get it out of
25:58
Speaker 1: your body. So when blood flow reach turns again, all
26:01
Speaker 1: of those white blood cells come to the site of
26:03
Speaker 1: this problem, your brain, and they start cleaning up. Well.
26:07
Speaker 1: When they do, and inflammatory reaction happens, and all of
26:10
Speaker 1: a sudden you have swelling in your brain and the
26:13
Speaker 1: process gets even worse. So these these um structurally challenged
26:17
Speaker 1: neurons don't just erupt immediately. They do immediately, but it
26:22
Speaker 1: can continue for hours and days afterwards. And all of
26:25
Speaker 1: this happens from a heart attack. But by applying cold
26:30
Speaker 1: temperatures and bringing hypothermion and somebody you can actually stop
26:34
Speaker 1: this process. You can stop the glutamate from ever being dumped.
26:37
Speaker 1: They're finding and so give time basically for your brain
26:41
Speaker 1: to to rebuild itself in the way it needs to
26:44
Speaker 1: by lowering that metabolic rate that your your neurons need.
26:49
Speaker 1: That's what it does for for a heart attack, cardiac arrest.
26:53
Speaker 1: They're definitely two different things. I looked it up and
26:56
Speaker 1: someone's gonna say, you guys should do a podcast on
26:57
Speaker 1: that because you don't know what you're talking about. Right,
27:00
Speaker 1: it's coming. So probably after that we should take a
27:03
Speaker 1: little break, huh, I think. So you want to get
27:05
Speaker 1: some tea, yeah, and uh we'll be back with more
27:09
Speaker 1: cool stuff. All right, So how is this magic done?
27:32
Speaker 1: It's pretty easy. Actually, yeah, it's easy in theory. But
27:36
Speaker 1: there are generally three stages UM for therapeutic hypothermia, and
27:40
Speaker 1: they are induction, maintenance, and rewarming, and they are all
27:45
Speaker 1: very carefully monitored and have to be done just right. Uh.
27:49
Speaker 1: So when they go to cool the patient, um, they
27:52
Speaker 1: will first thing you'll do is sedate them because shivering. Uh,
27:55
Speaker 1: shivering is the body's way of trying to stay warm.
27:57
Speaker 1: Like your body wants to be warm, is going to
28:00
Speaker 1: do everything it can until you die, like Jack Nicholson
28:03
Speaker 1: outside the maze and the shining exactly to stay warm. Yeah,
28:07
Speaker 1: and you can't have a body shivering because number one,
28:09
Speaker 1: it fights off that hypothermia you're inducing, right. Number two,
28:13
Speaker 1: that uses a lot of energy, which is what you're
28:16
Speaker 1: combating right there. You're trying to slow the metabolic right,
28:19
Speaker 1: not increase it, right, and you want a patient that's
28:21
Speaker 1: still as well. Like one of the problems I've seen
28:24
Speaker 1: is the problem with doctors like performing in these conditions
28:28
Speaker 1: because like stop squirming. Well that too, and they have
28:31
Speaker 1: to keep the room very cold. It's not like they're
28:34
Speaker 1: in like an eighty degree room and they're trying to
28:36
Speaker 1: keep them like everything is cold. So the doctors have
28:38
Speaker 1: to perform under those circumstances too, so they may shiver themselves.
28:42
Speaker 1: But to keep the patient from shivering, they just solve
28:45
Speaker 1: that problem by injecting them with the paralytic exactly, so
28:48
Speaker 1: now they're nice and still they're cooling down. Uh. The
28:52
Speaker 1: cheap way to do it, which is um and they're
28:54
Speaker 1: not doing it because it's cheap, but um ice packs
28:57
Speaker 1: basically armpits growing chest. They're basically wrapping your legs up
29:02
Speaker 1: and everything they can with ice packs, and that's just
29:05
Speaker 1: gonna cool you down pretty quickly. Um. Like you said,
29:10
Speaker 1: they will sometimes use like catheters or a chilled saline solution.
29:14
Speaker 1: Those are more invasive and more dangerous. They also work
29:17
Speaker 1: a lot quicker. Yes, very much. And I think they
29:20
Speaker 1: want to cool people down pretty quickly too, um, which
29:24
Speaker 1: is I don't think they want to do the cooling
29:25
Speaker 1: parts slow. No, And that's a really good point. I'm
29:28
Speaker 1: glad you brought that up. Especially if you're bringing a
29:31
Speaker 1: patient's body down, um to a really low temperature, you
29:37
Speaker 1: have to protect against ice crystals forming in the cells
29:40
Speaker 1: because that can erupt your cells and that's a whole
29:43
Speaker 1: set of other problems. Right, So if you bring the
29:46
Speaker 1: temperature down very quickly, you can prevent ice crystals from forming,
29:50
Speaker 1: that's right, because they require time to form. Yeah, if
29:54
Speaker 1: it's so, if it's super fast, they won't they won't form.
29:56
Speaker 1: That's the impression I have. Okay, So during the maintenance phase,
29:59
Speaker 1: it's you know exactly how it sounds, are just maintaining
30:03
Speaker 1: that temperature, keeping a very close eye again, using these
30:07
Speaker 1: cold water packs or forced cold, forced air blankets and
30:11
Speaker 1: things like that. Um huh, they sound kind of cool,
30:16
Speaker 1: the forced cold their blanket that. Yeah, they'd be nice
30:18
Speaker 1: for these Atlanta summers. Get ahold of one of those. Uh.
30:22
Speaker 1: And there are a lot of risks along the way.
30:24
Speaker 1: Arrhythmia is a very big risk. Uh. And electrolytes leaving
30:29
Speaker 1: like potassium, which is necessary for the heart muscle to
30:33
Speaker 1: function as it should. Um, so they're they're pumping the
30:36
Speaker 1: electrolytes back into you because you're losing them. So again
30:41
Speaker 1: they're just maintaining everything. And then the rewarming part has
30:44
Speaker 1: to be done very very slow. Uh, otherwise you know,
30:48
Speaker 1: very bad things can happen. And we're talking um point
30:52
Speaker 1: to seven to point nine degrees per hour fahrenheit fahrenheit
30:58
Speaker 1: point one five to point five degrease celsius per hour. Yeah,
31:01
Speaker 1: those super very slow rewarming process, that's right. But if
31:05
Speaker 1: you've got a good forced air blanket, you can really
31:08
Speaker 1: control the warming. You get a good brand, not some
31:12
Speaker 1: off brand. And again they're not like, oh well if
31:15
Speaker 1: we um, if we heat the person back up at
31:21
Speaker 1: point one five degree celsius per hour, then this is
31:24
Speaker 1: what's going to happen. On a cellular level, like they're
31:27
Speaker 1: not quite there yet. They just know that that's the
31:30
Speaker 1: sweet spot for rewarming somebody, So chuck. One of the
31:34
Speaker 1: really um problematic side effects with rewarming a person is um. Yeah,
31:41
Speaker 1: they're like, why you start to get gaming while you
31:43
Speaker 1: were under um is uh blood clots. So when you're
31:49
Speaker 1: when your blood stops pumping because your metabolic rate is
31:52
Speaker 1: so low, the blood inside you starts to form clots
31:57
Speaker 1: thanks to your red blood cells and your platelets and um.
32:01
Speaker 1: When you warm back up, all of a sudden, you
32:03
Speaker 1: have clots all over your body. And that's a real
32:06
Speaker 1: problem that that alone can kill you. And that's part
32:08
Speaker 1: of the problem with the rewarming process. But it turns
32:11
Speaker 1: out that investigation into animals that hibernate, they found that
32:16
Speaker 1: animals have some sort of technique to where their red
32:20
Speaker 1: blood cells just kind of disappear, and then once the
32:23
Speaker 1: animal comes out of hibernation, it reappears. They don't even
32:27
Speaker 1: know where they go, no, but they do know that
32:29
Speaker 1: they don't get rid of them somehow and then regenerate
32:32
Speaker 1: some other ones because their reappearance is so fast that
32:35
Speaker 1: they just think the body somehow absorbs them and then
32:39
Speaker 1: releases them again. Yeah. And the other really cool thing
32:42
Speaker 1: and we're kind of into hibernation right now, which we'll
32:44
Speaker 1: talk about in more detail, but um, white blood cells. Uh,
32:49
Speaker 1: Hibernators remove white blood cells from their blood and storm
32:53
Speaker 1: in the lymph nodes and then about an hour and
32:55
Speaker 1: a half after these animals awake, they reappear. And this
32:58
Speaker 1: has a couple of functions. One is, when you're an
33:02
Speaker 1: animal undergoing hibernation, Uh, your immune system is going to
33:06
Speaker 1: be compromised because as white cells are in storage. Right,
33:09
Speaker 1: that's a problem. Yeah, it's a problem. But just knowing
33:12
Speaker 1: that animals can do these neat little tricks with their
33:15
Speaker 1: platelets and white blood cells, uh, could have like big
33:20
Speaker 1: effects on us if we can figure that out for ourselves.
33:22
Speaker 1: Well yes, specifically also chuck, because remember when we were
33:25
Speaker 1: talking about, um, your your neurons dying. Yeah, and when
33:29
Speaker 1: you reperfuse, when you bring blood back to the brain again,
33:33
Speaker 1: one of the things that brings with it is those
33:35
Speaker 1: white blood cells and they start going on the attack.
33:38
Speaker 1: So if you can figure out how to take white
33:40
Speaker 1: blood cells out of the equation, it's going to reduce
33:43
Speaker 1: things like post warming swelling, which can give you brain
33:47
Speaker 1: damage itself. Yeah, and you talked about the heart lung machine.
33:50
Speaker 1: One of the big dangers with that machine is a
33:53
Speaker 1: septic sepsis. And if you have those uh white blood
33:57
Speaker 1: cells stripped away, then you're not going to be at
33:59
Speaker 1: risk for that, right and um, they'll be able to
34:03
Speaker 1: uh hang on to blood longer. Right now. Blood donations
34:06
Speaker 1: can only be kept a weak um it goes rank quick, yeah,
34:12
Speaker 1: and um transplant organs can be UM basically cryo protected
34:18
Speaker 1: for longer too, which is pretty neat. So uh, I
34:21
Speaker 1: guess we should talk about hibernation for a minute because
34:23
Speaker 1: it's one of the neatest things in nature. I think,
34:26
Speaker 1: uh in torp or basically torpor short periods of hibernation
34:33
Speaker 1: reduced body temperature and inactivity. And when you link a
34:36
Speaker 1: bunch of torpors together, that's full on hibernation. So yeah,
34:41
Speaker 1: it's also like a like hibernation light too, Yeah, you
34:46
Speaker 1: know what I mean, Like you can you can be
34:48
Speaker 1: I think a bear inners torpor where it's it wakes
34:52
Speaker 1: up like every once in a while and eats or
34:54
Speaker 1: poops or does something. And then there's some animals where
34:57
Speaker 1: you can just shake them like this and they will
35:00
Speaker 1: not wake up and they're in full on hibernation. Yeah,
35:04
Speaker 1: and the animals have to prepare for this. They just
35:06
Speaker 1: don't go betty by and stay asleep for a long time. First,
35:09
Speaker 1: they become diabetics basically by gorging on food and becoming obese.
35:14
Speaker 1: It sounds familiar, uh and um, but it doesn't affect
35:19
Speaker 1: like humans does. It doesn't make them unhealthy, like their
35:21
Speaker 1: body knows it's preparation for hibernation, knows what to do
35:24
Speaker 1: with it exactly. Plus they're probably also eating unprocessed foods too,
35:29
Speaker 1: which I think makes a difference. Yeah, you know, I
35:32
Speaker 1: think so. Um, they don't atrophy like humans do. Like
35:36
Speaker 1: when we lay around in bed, we don't our muscles
35:38
Speaker 1: will atrophy. Um. Animals can go months and months without moving.
35:43
Speaker 1: Spectacular spectacular. It also kind of suggests that humans aren't
35:46
Speaker 1: supposed to hybridate. Yeah. Well, although you know, when they
35:51
Speaker 1: found some of these frozen people, they start to think
35:53
Speaker 1: maybe human hibernation isn't such a bad thing. Um. Their
35:57
Speaker 1: lungs when you hibernate, become covered at the really thick
36:00
Speaker 1: like mucacy uh deposits um. It basically looks like a
36:05
Speaker 1: human with asthma, but it's you know, a protective measure. Again. Uh,
36:10
Speaker 1: they go in their brains kind of um go into
36:12
Speaker 1: a stage that looks like early Alzheimer's. Again, not a
36:15
Speaker 1: bad thing, it's just preparation. Uh. And it's weird. I mean,
36:20
Speaker 1: it looks like animals are almost dying when they're preparing
36:24
Speaker 1: for hibernation. Well some cases, and sometimes they do, especially
36:28
Speaker 1: when they're forced to come out of hibernation and then
36:30
Speaker 1: go back in. Their energy stores aren't aren't built for
36:35
Speaker 1: that kind of thing, like, so they probably will die
36:37
Speaker 1: because they'll start to death because it required so much
36:39
Speaker 1: energy to wake back up again. Or they're also vulnerable
36:43
Speaker 1: to predators too. Yeah, good point, which makes you wonder, like,
36:47
Speaker 1: what's the point of hibernation, And the point is, well,
36:50
Speaker 1: it's they don't have enough energy to go elsewhere when
36:54
Speaker 1: temperatures get cold, so they just kind of shut down
36:57
Speaker 1: their metabolic demand when food becomes years. Yeah and um,
37:02
Speaker 1: for the longest time, we didn't think that any um
37:05
Speaker 1: uh primates could hibernate until two thousand four when they
37:10
Speaker 1: found a lemur from Madagascar that could hibernate and uh,
37:16
Speaker 1: well at least go into the regular torpor hibernation light
37:20
Speaker 1: still and they said, we share about nine of our
37:23
Speaker 1: genes with the lemur, and they said it's basically like
37:26
Speaker 1: our cousin. Yeah, I mean that. The doctor basically said
37:29
Speaker 1: it would be really remarkable if the ability to hibernate
37:32
Speaker 1: light within that two that we don't have, So basically
37:36
Speaker 1: humans may have more of an ability to do this
37:38
Speaker 1: than we think. It would just have to be medically induced. Well,
37:41
Speaker 1: you know who demonstrates that very well, Chuck. Who's that?
37:44
Speaker 1: A man named mitsu take Uchi Koshi. Oh, yeah, we
37:47
Speaker 1: talked about him. What do we talk about him? And
37:49
Speaker 1: was it cryogenics episode? It was a long time ago.
37:53
Speaker 1: I do remember that one. Yeah, that's a good one.
37:57
Speaker 1: That was a good title. But yeah, I remember this
37:59
Speaker 1: guy though. For so. He is a Japanese man who,
38:03
Speaker 1: at age thirty five, was hiking with some friends in
38:07
Speaker 1: Japan and he decided to turn back by himself to go,
38:11
Speaker 1: I don't know, get something out of his car, and
38:14
Speaker 1: he wandered off and apparently in a meadow, um tripped
38:18
Speaker 1: over a rock and fell and hit his head on
38:21
Speaker 1: another rock and laid there in exposed to these cold
38:26
Speaker 1: temperatures on this mountain for twenty four days, and he
38:30
Speaker 1: was found basically in a state of hibernation. His body
38:33
Speaker 1: temperature was through the floor and um, he had almost
38:39
Speaker 1: no pulse. His temperature was seventy one degrees which is
38:43
Speaker 1: twenty two degrees celsius. That's his body temperature. That's pretty
38:47
Speaker 1: that's like a hypothermic state. And he was in this
38:51
Speaker 1: weird kind of state of suspended animation for twenty four days.
38:55
Speaker 1: He went without food, water, nothing, just laying there um
39:00
Speaker 1: living in some weird way until he was rescued and
39:03
Speaker 1: returned to um complete normalcy. Yeah, it's like the lady
39:07
Speaker 1: the skier who was frozen, not nearly for as long.
39:10
Speaker 1: But these cases where humans bodies are defying what we
39:13
Speaker 1: thought they could do, you can give us insight into, like, hey,
39:16
Speaker 1: how do we manipulate this for good? How do we
39:18
Speaker 1: use this to get to the stars. Alright, So I
39:21
Speaker 1: mentioned earlier that NASA was kind of leading the charge
39:24
Speaker 1: for UM this really cool suspended animation where you're basically
39:31
Speaker 1: freezing a person like Han Solo um in carbonite. Yeah,
39:35
Speaker 1: except it's not carbonite. It's not exactly like that, but
39:39
Speaker 1: it's it's sort of like that. Actually, it's not like
39:42
Speaker 1: that at all. Right, um And where NASA dropped off,
39:47
Speaker 1: the U. S. Army picked back up with some funding
39:50
Speaker 1: because they basically said on the trauma hospitals during wartime
39:57
Speaker 1: are chaos because you're trying to to save a person.
40:01
Speaker 1: You're trying to treat their immediate wound, you're trying to
40:03
Speaker 1: stabilize them, you're trying to make them better, you're trying
40:06
Speaker 1: to prevent blood loss. It's it's not an easy thing
40:09
Speaker 1: to do. It's not like mash you know, where they
40:11
Speaker 1: just make it look super simple. Right, Well, everybody's drunk
40:13
Speaker 1: on homemade gin. Yeah, so they're thinking, Um, I wonder
40:17
Speaker 1: what that stuff tasted like I always wondered. But they're
40:19
Speaker 1: still they seem to like it pretty much pretty well
40:21
Speaker 1: because they didn't have anything, I know, but they really
40:24
Speaker 1: seemed to enjoy it well. The way they handled it
40:26
Speaker 1: was very much like a fine martini. But you know,
40:28
Speaker 1: it's just like swill. I don't know they were at
40:31
Speaker 1: it for several years. Yeah, that's true. We'll have to
40:33
Speaker 1: ask Allan all of the um Man, I'd love to
40:36
Speaker 1: meet that guy. Oh yeah, one of my heroes. For attention,
40:39
Speaker 1: Alan all the reach out to us. So Chuck can
40:43
Speaker 1: meet too, that would be great. My brother met him,
40:45
Speaker 1: I'm sure he did. Probably gets Christmas cards, phone, No,
40:49
Speaker 1: but he did get a picture with him, which is
40:51
Speaker 1: pretty neat. It's nice. Um, So where was I? Oh, yeah,
40:54
Speaker 1: mash operating rooms. Yeah, because if you're a doctor, even
40:59
Speaker 1: in a battle field hospital, you're like, I want a
41:02
Speaker 1: coffee break too, and so to be like, I don't
41:04
Speaker 1: have time for this guy right now. Freeze him to
41:07
Speaker 1: have that ability that would be magnificent. Or if you
41:11
Speaker 1: did have time for the guy, but you literally didn't
41:14
Speaker 1: have time to fix these horrific wounds that he came
41:18
Speaker 1: in with, you could also say, freeze him to buy
41:21
Speaker 1: me some time, and that will let will give you
41:24
Speaker 1: the time to basically operate on this guy and completely
41:29
Speaker 1: repair heart or his brain or what have you. Um.
41:33
Speaker 1: And that's what medically induced hypothermia does. It's just it
41:36
Speaker 1: buys you time for either the body to heal itself
41:39
Speaker 1: in ways we don't understand, or for you, the surgeon
41:41
Speaker 1: to sew somebody up who without hypothermia would just be
41:46
Speaker 1: a lost cause. Yeah. There's a doctor named Sam Tishrman
41:51
Speaker 1: from the University of Maryland chirps working with the University
41:55
Speaker 1: of Pittsburgh. UM, what are they panthers? University of Pittsburgh,
42:02
Speaker 1: pitt panthers. I think so that sounds right. It does,
42:07
Speaker 1: we'll go with panthers. Panthers. Uh. If I got that right,
42:11
Speaker 1: I'm so sorry, Pittsburgh. We'd love you. UM. But he
42:14
Speaker 1: is working hard to UM basically UH put patients into
42:19
Speaker 1: severe hypothermia or suspended animation. And they're calling this emergency
42:24
Speaker 1: preservation and resuscitation. And this is the one that they
42:28
Speaker 1: haven't yet experimented on humans. They think they're pretty close,
42:32
Speaker 1: but this is the one where they flushed the body
42:35
Speaker 1: with freezing cold saline solution UM, which prevents ice from forming. Yeah,
42:40
Speaker 1: and it's worked on dogs, and I think it works
42:44
Speaker 1: on dogs. Got work on humans. Well, they did some
42:46
Speaker 1: experiments on pigs too, because one of the one of
42:51
Speaker 1: the things they think they can do where it's not
42:54
Speaker 1: like if you've had a hard cardiac arrest or a stroke,
42:57
Speaker 1: but again with trauma like a gunshot, you just can't.
43:00
Speaker 1: And I didn't I never knew this. You can't resuscitate
43:03
Speaker 1: a person with CPR that's had blood loss due to
43:06
Speaker 1: trauma it's completely different than cardiac arrest. Why because it's
43:09
Speaker 1: a close circulatory system has been opened. I have no idea.
43:13
Speaker 1: I bet that's it. Because of the dropping blood pressure.
43:15
Speaker 1: It's just not working. It's like sucking through a straw
43:19
Speaker 1: that has a hole beneath your lips. Like a lot
43:22
Speaker 1: of it's escaping, A lot of the air's escaping, so
43:24
Speaker 1: you can't get as much draw. Yeah, I guess that
43:27
Speaker 1: makes I bet that's what it is. All right, Well
43:28
Speaker 1: we'll probably find out. Um, but with ellen all with
43:33
Speaker 1: trauma like a gunshot wound or something, or a stab
43:35
Speaker 1: wound where you've lost so much blood you're dying. Um.
43:39
Speaker 1: This is when they're using these super super cold temperatures. Um.
43:43
Speaker 1: It's a tube inserted into the a orda literally And
43:46
Speaker 1: they've done this on pigs. In two thousand six, they
43:50
Speaker 1: examined um deep profound and ultra profound freezing of pigs
43:56
Speaker 1: who had uncontrolled bleeding wounds. And I imagine and then
44:01
Speaker 1: imagine they induced those as well. Piggy grad student. Yeah,
44:06
Speaker 1: there's one creep post doc to get to do you know,
44:09
Speaker 1: all the stabbings. Um, that's why I'm here. I'll get Ronnie.
44:15
Speaker 1: Um and they found that the ones who went underwent
44:18
Speaker 1: the most profound hypothermia had the highest survival rates, like
44:21
Speaker 1: those French soldiers on the battle exactly. And then in
44:25
Speaker 1: two thousand they did the same thing with dogs, except
44:27
Speaker 1: that why they weren't stabbed, it was dogs and cardiac arrest. Um,
44:32
Speaker 1: they may have induced that too though, come to think
44:34
Speaker 1: of it, they'd be like, do you want this bone?
44:37
Speaker 1: Now you can't have it. But they used ice cold
44:40
Speaker 1: ceiling in that case, and their chances of survival with
44:43
Speaker 1: no brain damage really increased. So, um, it's you know,
44:48
Speaker 1: there are risks though it's not the easiest thing to do,
44:50
Speaker 1: like we said, and um, I know pneumonia was one
44:54
Speaker 1: of the risks for years, um, even with just the
44:58
Speaker 1: regular cooling, right. Uh. Yeah, pneumonia slowed heart rate. Apparently
45:04
Speaker 1: you can enter hyperthermia while you're being rewarmed, Like you
45:07
Speaker 1: get way too hot, your body temperature increases too dramatically.
45:11
Speaker 1: There's a lot of problems that. Blood clotting is still
45:14
Speaker 1: an issue and probably will be for a while. Yeah.
45:16
Speaker 1: With Tishrmann's case, trying to use humans though, there's a
45:19
Speaker 1: couple of problems. Um. One is they have to get
45:23
Speaker 1: consent from a person to undergo an experiment like this,
45:26
Speaker 1: but you can't give consent when you're wheeled in there
45:29
Speaker 1: unconscious from a cardiac arrest. So what he's trying to
45:32
Speaker 1: do is just spread the word, literally, just spread the
45:35
Speaker 1: word to the citizens in his area that there's this thing,
45:40
Speaker 1: and if your husband or wife has the cardiac arrest,
45:43
Speaker 1: ask for the cold treatment where we completely pumped their
45:47
Speaker 1: blood out and replace it with frozen sailine. Using cold sailine.
45:51
Speaker 1: It's pretty amazing, it is. And you know, there's a
45:53
Speaker 1: lot of people who are still very skeptical of the
45:56
Speaker 1: idea that medically induced hypothermia can actually work, but there's
46:02
Speaker 1: also a growing body of studies that show that it
46:05
Speaker 1: does that has a significant impact. Like there were a
46:07
Speaker 1: couple there were several in two thousand two that really
46:10
Speaker 1: broke the thing open where it was like, these people
46:13
Speaker 1: have a twenty five percent chance of recovery without it,
46:16
Speaker 1: they have a fifty or seventy five percent chance of
46:18
Speaker 1: recovery with it, And that's really tough to ignore. It's amazing,
46:23
Speaker 1: amazing stuff into the future, Chuck, let's go. If you
46:28
Speaker 1: want to know more about medically induced hypothermia. Check out
46:31
Speaker 1: our podcast page for this episode. It's got a bunch
46:33
Speaker 1: of cool links and you can type therapeutic hypothermia in
46:37
Speaker 1: the search part how stuff works dot com and it
46:39
Speaker 1: will bring up this article of puns. And Uh, since
46:43
Speaker 1: I said search parts, time for listener mail, I'm gonna
46:48
Speaker 1: call this um Josh's theory on satire. Remember that we
46:52
Speaker 1: talked about that in the very recent show Clowns CNN. Uh.
46:58
Speaker 1: Do you want to summarize your position real quick that
47:00
Speaker 1: maybe satire is just a release and does it affect change?
47:04
Speaker 1: Is that the nuts and bolts of it. Yeah, Basically
47:05
Speaker 1: it lets the populace who's angry let off steam at
47:09
Speaker 1: the leadership without actually forcing the leadership to change. All right,
47:13
Speaker 1: So that brings us up to speed. And this is
47:15
Speaker 1: from Chelsea. Uh. She said, I just started listening under
47:18
Speaker 1: a year ago when a change in jobs landed me
47:20
Speaker 1: with a twenty five minute walk to and from work
47:23
Speaker 1: every day. I think she's in dublin. Um, she says,
47:26
Speaker 1: I find myself laughing out loud at your repartee. And
47:29
Speaker 1: my boyfriend is affectionately started referring to you as my
47:32
Speaker 1: nerd friends. But he's a listener. Now to it sounds
47:35
Speaker 1: like Dublin I'm actually writing in regard to Josh's theory
47:38
Speaker 1: on satire. It's a really interesting point, an angle I
47:41
Speaker 1: had not considered myself. I think though, that there's another
47:44
Speaker 1: way to look at it, which is that satire has
47:46
Speaker 1: the ability to plant the seed of dissent in a
47:49
Speaker 1: non threatening way and thus can eventually be a force
47:51
Speaker 1: of change. For example, someone may not be aware of
47:54
Speaker 1: a particular foible of a leader. That satirist points it
47:57
Speaker 1: out in a funny way. Now that someone has an awareness,
48:00
Speaker 1: without feeling preached at, and has it in their mind
48:03
Speaker 1: the next time the leader does something untoward, or perhaps
48:06
Speaker 1: they were just uh, they were aware of said foible,
48:09
Speaker 1: but the satirists opened their eyes to just how ridiculous
48:12
Speaker 1: and or dangerous it is. So while there's certainly a
48:15
Speaker 1: possibility satire connect as a placation or a way of
48:17
Speaker 1: letting off steam, there's also a very real possibility that
48:20
Speaker 1: can spark be the spark that ignites an eventual change.
48:23
Speaker 1: It is a good point. Yeah, that's from Chelsea and
48:26
Speaker 1: Morgan Hoffman. Thanks a lot, Chelsea Morgan Hoffman of Dublin, Ireland.
48:30
Speaker 1: Probably h well, she just said Dublin, Dublin, Georgia. I'm
48:34
Speaker 1: gonna go ahead and assume Ireland. Yeah, and boyfriend, yes,
48:37
Speaker 1: thank you both for listening. We appreciate it. Uh. And
48:40
Speaker 1: if you have a counterpoint, or your own theory or hypothesis,
48:44
Speaker 1: or just want to say hi or whatever, you can
48:46
Speaker 1: tweet to us at s y s K podcast. You
48:49
Speaker 1: can join us on Facebook dot com slash Stuff you
48:51
Speaker 1: Should Know, UH, you can send us an email to
48:54
Speaker 1: Stuff Podcast at how Stuff Works dot com, and as always,
48:57
Speaker 1: joined us at our luxurious home on the web, Stuff
49:00
Speaker 1: you Should Know dot com. Stuff you Should Know is
49:05
Speaker 1: a production of I Heart Radio. For more podcasts my
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