A new procedure could increase the amount of time emergency room doctors have to restore blood flow to victims of shootings or stabbings, before brain damage occurs, from just a few minutes to an hour.
In the clinical trial, researchers at the University of Pittsburgh Medical Center plan to put trauma patients into a kind of suspended animation by temporarily removing all of their blood and replacing it with cold salt water.
The procedure, called Emergency Preservation and Resuscitation, would stop the heart and brain activity, meaning the patients would be clinically dead. That has raised some ethical concerns.
Six medical centers are expected to take part in the Department of Defense clinical trial.
Dr. Samuel Tisherman is lead researcher of the clinical trial and is now working to extend it to the University of Maryland's Shock Trauma in Baltimore. He discusses the experimental procedure with Here & Now's Meghna Chakrabarti.
Interview Highlights: Dr. Samuel Tisherman
On how saline replacement works
"We're talking about patients who come in with penetrating trauma, like gunshot wounds, stab wounds. They've already had a cardiac arrest. They've probably lost more than half their blood volume. We do all our normal things to try to save them; they don't work. We would then switch to what we're calling emergency preservation and resuscitation, or EPR, and that would then entail placing a large tube we call a cannula or catheter directly into the aorta, and then pumping a large amount of ice-cold saline, which is just salt water. And the main point there isn't so much to get their blood out or use the salt water. It's mainly just that that's the fastest way that we've found to cool them. And the cooling is basically to decrease oxygen demands while there's no blood supply to organs and tissues and particularly the brain, and buy time for the surgeons to operate and control the bleeding."
On how chilling a patient aids in emergency surgery
"We recognize that what we currently do often doesn't work, and it's heartbreaking to do everything we possibly to can to try and save someone and not be able to do that. And recognizing that this type of hypothermia can be achieved in cold-water drowning, as you mentioned, as well as it's used every day by cardiac surgeons for particularly complex types of operations, that it might be able to help in this situation."
On ethical concerns over this trial
"Any kind of resuscitation, there's always a chance that the patient will survive and have significant brain damage from the cardiac arrest itself. We don't know if what we're doing is gonna increase that risk or decrease it, but we need to forge ahead."
- Samuel Tisherman, M.D., lead researcher of the Emergency Preservation and Resuscitation clinical trial. He is a professor in the Departments of Critical Care Medicine and Surgery at the University of Pittsburgh School of Medicine.
This segment aired on June 10, 2014.
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