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How Therapeutic Hypothermia Works · Stuff You Should Know

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