Posted May 02, 2007 at 06:32AM by Ryan C. Listed in: Biomedical Technology, Medical Devices Tags: Newsweek, Pennsylvania
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Emergency - Image 1 Today's life-saving techniques could be killing potential survivors, a Dr. Lance Becker from Pennsylvania suggests, in an article written by Newsweek's own Jerry Adler. In an emergency room, in a desperate situation where paramedics are trying their hardest to get the flatlining patient's heartbeat back, they might be doing more harm than good.

First of all, how does someone 'die'? A conventional answer would be that one's cells had died, the lack of oxygen causing irreparable damage to his brain and heart, effectively grinding all activity into a halt - a process that begins four or five minutes after the moment of pulse flatlining.

If cardiopulmonary resuscitation isn't appropriated before that time limit is over, 'death' as we know it occurs. However, after recently inspecting heart cells that have been starved of oxygen, researchers have begun questioning not only the methods we now use to resuscitate dying patients, but our idea of death itself.

"After one hour, we couldn't see evidence the cells had died. We thought we'd done something wrong," says Dr. Lance Becker, director of the Center of Resuscitation. It's to note that cells cut off from their blood supply die hours later, considerably much longer than the esteemed four-to-five minute window.

So what actually kills cells? Oxygen reperfusion, or the resumption of oxygen supply. When a cell is starved of oxygen for more than five minutes, it dies when its supply of oxygen is resumed immediately after. Becker blames apoptosis, a process controlled by mitochondria as the automatic 'kill switch' of abnormal cells, such as cancer. "It looks to us as if the cellular surveillance mechanism cannot tell the difference between a cancer cell and a cell being reperfused with oxygen. Something throws the switch that makes the cell die."

With this revelation, Becker hopes to change emergency response procedures as we know them. Instead of paramedics forcing the heart to beat and pump oxygen-rich blood with defibrillators and epinephrine shots, they should be doing the exact opposite: reducing oxygen uptake, slowing the body's metabolism and adjusting the blood chemistry for gradual and safe reperfusion. This would slowly but surely get the cells the oxygen they've been starved of, but not so fast that the mitochondria mistakes them for cancer cells and shut everything down.

It's not the anti-death pill, but it'd certainly help. A better chance of survival, a second chance at life. Good news? Definitely.

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