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How Cool Temperatures Can Save Lives

If controlled, hypothermia can help saving lives. Find out how!

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Cool temperatures have a series of health benefits. When the temperature is low, your brain works better, you sleep better, your body fights infections as well as inflammation better (just like ice packs reduce swelling and pain). Moreover, by constraining blood vessels in your skin, cold helps you look younger and healthier. If all these benefits weren’t enough, cold temperatures can even, in some cases, save lives. Let's take a look at some incredible medical and accidental cases where lowering body temperature prevented people from dying.

Cooling treatment at about 33°C

In 2012 Zach Conrad, a 36-year-old finance manager from the US, had a heart attack while he was on a bike ride. In the US, there are more than 356,000 out-of-hospital cardiac arrests every year. About 90% of them, treated with “traditional” resuscitation techniques, end up being fatal. Normally (if we consider “normal” what current medical technology is able to achieve) Zach would have probably died. Yet, some researchers are working on new resuscitation techniques. And Zach happened to have his heart attack in the right place for two reasons:

  1. He collapsed in front of an ER nurse, who could start cardiopulmonary resuscitation (CPR) within seconds. This prevented ischemia (the lack of blood flow to the entire brain) and reduced brain damage.
  2. His cardiac arrest happened not too far from Penn Medicine, a hospital utilizing a new cutting-edge procedure called therapeutic hypothermia.

At the hospital, Benjamin Abella, the clinical research director at the Center for Resuscitation Science, ordered Zach to undergo a 24-hour cooling treatment. By lowering his body temperature by only about 4 degrees Celsius, they were able to reduce inflammation and slow his metabolism. This helped the body recover from the resuscitation injury better than it would have done at a normal temperature. For about a week, Zach laid in a medically induced coma, during which he received post-arrest care: blood pressure support, cardiac catheterisation and mechanical ventilation.

Timely CPR and cooling also resulted in minimal brain damage. While Zach had lost two years of memory when he woke up (he thought it was 2010), within a short time his brain was able to recover much of the information. If this innovative technology wouldn’t have existed yet, Zach would have probably not been able to live another day.

Therapeutic hypothermia today

The term “therapeutic hypothermia” has gained medical value only in the last few years. Yet, we can find many historical references to the use of low temperatures in the treatment of certain diseases. It is believed that Hyppocrates himself (circa 450 B.C) advocated packing wounded soldiers in the snow.

Modern therapeutic hypothermia techniques for cardiac arrest patients have been slowly developing after 2000. In that year, the New England Journal of Medicine published the result of a clinical trial that showed how patients who receive this treatment had better chances of short and long-term survival, as well as better neurological outcomes. This technique hasn’t been perfect yet. The optimum method of cooling is yet to be determined, as well as the perfect temperature according to the specificity of each patient.

therapeutic hypotermia techniques
How therapeutic hypothermia is commonly induced today - Image Credit: health.howstuffworks.com

To understand how therapeutic hypothermia works, let’s start from the beginning: why do our bodies need oxygen? When we breathe, oxygen enters our lungs and from there reaches, through our blood, each one of our 37 trillion cells. In this way, our cells can break down food and get the energy we need to survive. The moment our lungs stop providing enough oxygen, our cells need an alternative way to meet the demand of energy. Otherwise, they start dying gradually. Hypothermia decreases the metabolic rate (and therefore the body’s need for oxygen) by 5% to 7% per 1 C decrease in core body temperature. Put simply, when our brain is in distress and receives less oxygen, we can put the body in a position to function with less oxygen. If done properly, we can prevent brain cells from dying and reduce, if not completely avoid, brain damage.

Accidental hypothermia at 13.7°C

Therapeutic hypothermia is a controlled medical practice. Yet, there have been uncontrolled accidental cases where cool temperatures have saved lives. Let’s have a look at one of them.

In May 1999 Anna Bågenholm, a 29-year-old Swedish radiologist, fell head-down into a frozen lake during a skiing trip to Norway. Her friends tried unsuccessfully to pull her out of the icy water. The rescue team reached them only 80 minutes after the accident and when they managed to take her out of the lake she was clinically dead. Her heart wasn’t beating and she wasn’t breathing. Her body was at 13.7°C (23 degrees less than what it would have been in normal conditions). "She has completely dilated pupils. She is ashen, flaxen white. She's wet. She's ice cold when I touch her skin, and she looks absolutely dead," the head of the emergency medical department, Mads Gilbert, said in an interview with CNN.

They decided to try to warm her up before declaring her legally dead. In fact, there was a chance that the low temperature had slowed down her brain enough to survive with the little amount of oxygen she had at her disposal (a small pocket of air under the layer of ice). A brain can normally survive only a few minutes without oxygen before irreversible damage sets in. But when the temperature is lower, metabolic reduction kicks in and the need for oxygen decreases.

Using a heart-lung machine, they pumped her blood out of her body to warm it up before circulating it through her again. Over several hours, her temperature gradually began to rise. About a day after Anna had fallen into the river, her heart started beating again. After 12 days, she woke up. While her brain wasn’t damaged, her nerves were and it took her about a year to be able to walk and move normally.

frozen lake
After falling into a frozen lake, Anna Bågenholm’s brain lasted 80 minutes with little to zero oxygen

Medical outcome of Anna Bågenholm’s case

Before this happened, no patient had survived being frozen to death at the University Hospital of North Norway (where Anna was treated). But between 1999 and 2013, 9 out of 24 patients survived hypothermic cardiac arrest.

These cases, together with other medical research, influence the development of technologies that utilize cool temperatures to save lives (such as therapeutic hypothermia). As we saw above, death is a process that gradually degrades the body’s cells. When we're warm, this process happens in minutes. When we reduce the temperature by only a few degrees, the process slows down. Lowering the body by a few degrees, we could find a way to have a few hours to save patients in a critical condition. By lowering the temperature even further, could we stop the degradation process completely and have years of time to save a patient?

Cryopreservation at -196°C

This is where human cryopreservation aka biostasis comes in. Human cryopreservation is an advanced medical procedure that, through the use of very low cryogenic temperatures, can preserve a body for as long as it’s necessary, for decades or even centuries. You might ask yourself, why would we need centuries to treat a patient? The answer is simple.

Today, people die of diseases that are incurable but that could possibly be treated in the future. Cryopreservation gives us a possible solution to this time gap. By lowering their body temperature (down to -196°C) and fully pausing the metabolic process after their clinical and legal death, we can preserve them until the day they could be cured (and until cryopreservation can be reversed). Their cells, without need for oxygen, won’t degrade and gradually die, as would happen at normal temperatures. In the future, when medical technology might be able to treat what caused their legal death, cryopreserved patients could be gradually “warmed up”, treated and revived. They could have a “second-chance” in life. But it’s only a chance, of course, as it relies on advanced future technology that is not yet available.

Conclusion

In the cases seen above, people’s lives were saved by medical personnel who pushed the limits of present-day medical technology. These people had the chance to live longer because doctors and nurses didn’t stop at what is considered “norm” today.

At Tomorrow Biostasis, we don’t want to stop either. There might be a way in the future to cure patients that are currently not curable. There might be a way to save their lives and allow them to live longer. If you are interested in the potential behind biostasis technology, feel free to schedule a call with us. If you want to join our community and push the research further, sign up here!

Tomorrow Bio is the worlds fastest growing human cryopreservation provider. Our all inclusive cryopreservation plans start at just 45€ per month. Learn more here.
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