January 14, 2023 • 49 mins
Physicians noticed centuries ago that people exposed to cold temperatures often have amazing recoveries from serious medical emergencies. Now medicine is learning how to purposefully induce hypothermia in order to buy time to fix otherwise fatal trauma. Find out all about it in this classic episode.
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Episode Transcript
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Speaker 1 (00:00):
M Hey everybody, it's Josh and for this week's select,
I've chosen our two thousand fifteen episode on therapeutic hypothermia.
It sounds weird and boring and it's a really super
science EPP. But sometimes sometimes those can be the best ones.
This topic is super interesting. It's a look at how
science can stave off death and hopefully it's the direction
(00:22):
that modern medicine is heading. Plus, if you get bored,
you can thrill the hearing us. Try to say cellular
level here or there. It's hilarious. Enjoy. I command you.
Welcome to Stuff you Should Know, a production of I
Heart Radio. Hey, and welcome to the podcast. I'm Josh Clark.
(00:49):
There's Charles W. Eager Beaver, Chuckers Bryant ready to get
its therapeutic hypothermia on. Yeah, baby, I'm chilling. Yeah, moving
at a glacial paste today, right, I am um, I'm
sorry for that. That was actually a poke at the
author of this article. Yeah, that's uh. That stood out
(01:10):
to me as well. I'm not telling you Jerry's over
there and stuff you should know. No, I'm done. Um. Yeah,
we were goofing off about this article and how stuff works.
That there were way too many cold puns for my liking.
There was a lot of puns, you know, a lot
lots of them. Yeah, this article stinks of punt it reeks.
(01:33):
So how you doing, man, how you feeling? I'm good? Uh,
it seems there's a sickness going around the office. Yeah,
which I thought we knew here in two thousand and
fifteen that if you're sick, you don't come into work,
especially when you have a liberal telecommune policy right like
we do. I realized, Um, I realized that people need
to come in and shoot video and recording all that.
(01:55):
But come in, you do that, and you leave, and
you wear like a plague doctor's mask the whole time
you're here too. Yeah. I mean, I have a biohazard
suit at my desk, but has a RiPP in it.
Anyone can wear it, has a ripping. It's very small
rental and cleaning fee. You're going to take a blood
sample of mine wearing that thing. And it occurred to
(02:17):
me as you were about to put it on, like
I don't know where that thing has been, Like, that's
a real biohazard suit and Chuck's going to use it
to open my skin. Yeah, this sounds very odd. Um,
we don't just do this in the office. We did
our blood Types episode live here in Atlanta, and we
actually took Josh's blood type on stage because you didn't
know it. No, I when we recorded the version in
(02:41):
the studio, I genuinely did not know it. Yeah, so
I took your blood on stage. You trusted me. I
did not wear the contaminated suit. No, you. You just
used your dirty hands with no like rubber gloves or anything.
Look at you. You're fine ish and you know your
blood type now, which was a positive like Jarius, So
(03:03):
we should release that whole live show. Is a just
a special yeah little bonus. Yeah bonus. That was the
word I was looking for. There's something special about it.
It's just a bonus. That was special. Yeah, it's a
good idea. Look for that soon people. So, uh, today, Chuck,
we're talking about therapeutic hypothermia and I am very excited
(03:23):
about this. This is my idea of this article. Yeah, Um,
it's pretty neat. I don't remember. I guess I first
heard of it from that Mosaic article that we both
read to the big sleep awesome article. And uh, if
you haven't figured out by now we have started to
on the podcast page for each episode, put related links
on there on our site stuff you should know dot com,
(03:45):
so that articles on there. There's a bunch of other
stuff on there too that will cover UM. But be
sure to check out that mosaic article. It's very neat
um and that article first introduced me to the concept
of therapeutic hypothermia or medically induced hypothermia as another another
term for it. I don't prefer target targeted temperature management.
(04:07):
That sounds yeah corporate, Yeah, very corporate. You know the
HMO term for it, like we'll we'll call it this
because it'll less than the likelihood that we'll get sued
or something exactly. Yes, yeah, I agree. But it's been
around for a while, and the the idea that exposing
people to lower temperatures to allow for better medical interventions,
(04:29):
which is the whole basis of therapeutic hypothermia UM, has
been around at least since the Napoleonic Wars. Yeah, it's
pretty neat. I was interested to find that out. They
noticed way back when in the eighteen hundreds early eighteen hundreds,
uh that troops in battlefield trauma, wounded soldiers would the
ones who were not kept warm and cozy by the
(04:51):
fire or in their tents, right, they're just left out
on the battlefield and the coals. Yeah, they actually fared better.
And they were like, wait a minute, is uh And
of course they had no idea at the time what
was going on. No, they're like, did you notice that? Yes,
I did notice that the heart well back to our brandy, Yeah,
pretty much. But they did notice that the ones who
were warm did a lot worse than the ones that
were left out in the cold, which is super interesting. Yeah,
(05:13):
But the the real investigation into what was going on
there didn't start until the thirties with a guy named
Dr temple Faye, and he was actually the first guy
to write about using therapeutic hypothermia. I think in n
was the first paper about it. But he was using
it for a full decade or so before then, basically
(05:34):
putting his patients in ice baths, opening the windows to
their room during the winter, and um, just basically using
any means he could to lower the temperature for I
think I think he had he was using in a
traumatic brain injury patients. Yeah, and I'm sure he did
a lot of explaining along the way to family members
that were like, hey, can you close the window and
(05:55):
warm up my husband here? And that. He was like,
all right, you wanted to I think back then too,
he was like, it's the thirties and this guy is
a traumatic brain injury. Really, there's nothing I can do
to make it worse, the prospects worse, So why don't
you just lighten up their family member? So there was
another pioneer in the fifties named Dr Peter safar Um
(06:17):
s A f A R. And he actually began experimenting
around with this in the e er as well, trying
to reduce tissue injury uh and brain image from a
lack of blood flow. Uh. And this was mainly at
the time in like stroke patients, cardiac arrest patients and
what we'll talk more about it. There's all sorts of
well not all sorts. There are several uses like cases
(06:40):
where you would want to use this and UM ranging
from cardiac arrest to like a gunshot wound to I think,
what is the infant situation? Come again, it is called chuck.
It's a type of encephalofy were ummic encephalofy. Yeah, where
your natal basically the blood flow the lack of blood
(07:02):
flow to the brains cut off for whatever reason, like
maybe the umbilical cord gets rappidly on the baby's neck
or what have you. Um, it leads to a swelling
in the brain, and they started using it to medical
the hypothermia to treat that. That's right, And that was
in the fifties, right, Yeah, the fifties and sixties is
(07:23):
when Dr Safar was doing his work. So this this
is all kind of going on on the side and
um experiments into hypothermia had kind of a bad name
thanks to the Nazis, and a little bit also the
Japanese and World War Two. But the Nazis, especially at
Dock how the concentration camp or the death camp there
(07:46):
um experimented using unwilling human subjects. Uh, they experimented on
the effects of hypothermia in people's bodies. They did all
manner of horrible, grizzly, gruesome stuff for they recorded the
data and there was a long debate over the years
over whether that data could be ethically used. And on
(08:07):
one hand, people were saying, no, it's the Nazis. They
used unwilling subjects. Is it amounted to torture in the
name of science, and I just used air air quotes, right.
And then other people said, well, wait a minute, these
people died, um whether and we're whether they wanted to
or not. They were made to be these test subjects
(08:28):
and they gave their lives. We can honor them at
least by using the data that was cold from it. Well,
once they really dug into the data that the Nazis
had accumulated, it was just like rank amateurs performing scientific experiments.
They followed like almost no protocol. They did terrible record
keeping of descriptions of subjects and things like that. So um,
(08:51):
it's almost like you just have to toss it out
because you just can't trust it scientifically the data. But
but the idea that people were exposed forcibly to hypothermic
conditions kind of gave hypothermia a bad name. So these
guys experimenting with the stuff, it was fringe science for
a while. Yeah, and then it started to come into
(09:12):
the mainstream and then everybody said, well, wait a minute,
hypothermia has all these bad side effects. Let's just table
it for now. Yeah. In the in the fifties to
NASA was doing a lot of work during the Space
Race because the idea was and this is really sort
of two parts. There's the the modern day uh cooling
like that's not freezing somebody basically, and then we also
(09:36):
have what's called suspended animation, which we'll get too later.
Those are totally different things, totally different things, but they
follow the same process initially, right yeah, um, well sort of,
I mean the methods are different, but the same idea
basically is to slow the body down, sown the heart rate,
slow down everything, your metabolism. Yeah. Um. But NASA was
doing this because they put a lot of money into
it because they thought two things. One you could protect
(09:58):
astronauts from cosmic rays and the other is basically straight
up alien like we can freeze people on long journeys
into space and then unfreezing when they get there, which
is not just alien. That's a bunch of sci fi movies.
But there was a doctor named James Lovelock back in
(10:19):
the day who was um freezing hamsters until they froze
and then basically until he couldn't hear heartbeat frozen, yeah,
they were clinically dead. Yeah, and then they would he
would put a little, uh, a little hot teaspoon against
their belly and warm him back up, and he found
that they were actually okay, and he was able to
revive them some of them. Well sure, yeah, I'm sure
(10:40):
there were losses along them, but I mean even one
coming back to life and seeming normal again, it is
pretty significant. It's a significant finding, Yeah, because basically the
idea was planted all of a sudden that hypothermia can
kill you or it can preserve you and keep you
from dying in an extreme situation, right, which is kind
(11:02):
of counterintuitive. Like you think of people who undergo hypothermia
or you know, being exposed to extremely cold temperatures, they're dead.
I mean, we've all seen the shining, we know the end. Yeah,
But apparently there's a rule of thumb among the er
physicians and staff that there's no such thing as a
cold dead body. I thought it was measured twice cut once.
(11:26):
It's a little different. That's for the surgeons. Um, No,
there's no such thing as a as a cold dead body.
You're only dead when you're warm and dead, right, Because well,
there's been some some cases throughout the years. The one
that spectacular one. Yeah, this lady um was she with
Norwegian on a boggenhorn. Um, I don't even know what
(11:48):
that is. It's not an oom out, it's a single
circle above that A. That's a it's a very Norwegian. Yeah,
death metal band name totally. Uh So she was skiing
and um, actually I think she was Swedish, but she
was on holiday skiing in Norway. Um fell headfirst into
a frozen stream and was trapped under ice, submerged for
(12:10):
eighty minutes, stopped breathing, heart stopped. Yeah. I mean she
was well known. She didn't drown. They thought she drowned
until they reheated her. Ten days they reheated her and
she was fine, Like weeks and months later she fully recovered.
And basically, if you're underwater warm water, you have a
(12:33):
few minutes at most. But what they discovered was if
you actually go into hypothermia, it can preserve your body. Um,
which was amazing and a big breakthrough into like, hey,
maybe we can use this right. Yeah, she was one
of a few a handful of people and we'll talk
about some others too, but um, that what researchers into
(12:55):
hypothermia I've learned and why they figured out that they're
you're not cold and dead you're just warm. And debt
is that it's not the the the addition of cold
or the exposure to cold that kills you. It's warming
back up in the wrong way too rapidly under the
wrong circumstances stances that that's what can kill you. Yeah,
(13:19):
it seems like it's a very fine line between well,
we'll talk about the process, but you have to do
it just right on the cooling side and the warming
side if you want to be successful right exactly. You know,
it's they haven't quite figured it all out yet. This
is in the very uh nascent stages. Still. It is
ridiculously primitive and and to the point where it's kind
(13:40):
of like if you're a doctor experimenting with this, you
you would be like, there's a d chance that your
dad is going to die under normal circumstances. We have
this one radical technique we can try that might help.
Can we try this? And that that that whether they
had lives or dies after being given medical hypothermia, he's
(14:04):
still going to end up as like the subject of
a major paper that would be written, because that's where
it's at right now. Yeah, And I read one doctor
said that they they think they pretty much know, it's
super possible and we'll work, he said, But it's the
the doing of it that's just really really hard. Exactly. Yeah,
I mean like it makes a complete sense intuitively, we
(14:25):
understand like what it's doing. It's just yeah, the fine tuning,
the nuance behind it that it's still kind of mysterious.
The most brilliant doctors say, it's just really hard. He said,
it's really dog gone hard to do. It kind of
makes you go, yeah, you know, is that the quote?
He know, his quote was, it's really dog gone hard.
And then my quote was, but we'll talk about medical
(14:48):
hypothermia and what it is specifically, uh, in just a
minu alright, so therapeutic hypothermia. Hypothermia is basically when you
(15:17):
lower the body temperature for various reasons to keep it alive.
And right now, what they're mainly doing now, this isn't
the second wave, which is freezing somebody. This is just
cooling a body before and after surgery to help them
increase their chances of survival. Basically, right, your your body. Um,
(15:41):
and they're doing that now on this side, they're just
not doing the other quite yet on humans. Yes, um,
so under normal circumstances, your body maintains a normal core
body temperature, normative temperature because what it's called, right, and um,
that's somewhere between like nineties in nine point six degrees
(16:02):
is a normal human core body temperature. And all of
this is and dude, do you remember and like when
I went on that crazy, weird metaphysical tangent and does
the body replace itself? Somebody wrote in and said, check
this article out, like here's a really great explanation of
why things live, where life comes from. And it was this, um,
(16:24):
this idea, it's a physics based idea of life and evolution.
And it says that because of entropy, because of one
of the laws of thermodynamics, that atoms will arrange themselves
in a way that they can take in energy and
dissipate heat in a really efficient manner. And so of
course they're gonna atoms are eventually going to arrange themselves
(16:46):
into life. It just makes total sense. Right, So, being
living things like we are, we take in energy and
we dissipate heat, and that's what forms our core body temperature. Right.
With therapeutic hype of thermia, what you're doing is lowering
the metabolic rate through the addition of cold, and so
(17:08):
we put out less heat, and by doing that, we're
also lowering our energy demand, so that that that little
engine that's going all the time and our cells and
our body in general gets slowed down. And it's not
altered in any way except for the speed and the
energy consumption. It's just slowed down. It's doing everything slower.
(17:30):
And you can do that simply by lowering the temperature
of the person. Yeah, and it's it's not just lower,
it's um it doesn't need to be faster. Does that
make sense, Like the heart beat slower because it doesn't
need to beat any faster, not like your body is struggling.
Your body is still doing fine. It's just reducing the
(17:50):
demand for stuff like blood flow and neurotransmitter action and
stuff like that exactly. And ultimately, what your heart does
is pumps blood. And what your blood has this, among
other things, oxygen, and your cells need oxygen to carry
out these metabolic processes to burn energy, right, So if
they need less, then your heart doesn't have to beat
(18:11):
as much. It's like you said, it's just the normal processes,
but on a much slower scale. Pretty awesome stuff. It is,
and it's just through the application of colder temperatures. Oh yeah,
and in this case UM, and we'll get to how
to do it. But in this case you're not I
mean you're literally cooling the body with like ice packs
and cold blankets and stuff like that pre surgery and
(18:33):
post surgery. It's not the suspended animation one that we'll
get to when they're actually like pumping frozen saline through
your pains. No, there are, but there are some UM
techniques for medically induced hypothermia that do put in like
chilled saline to chill your body down very quickly. But
(18:53):
it's not like replacing your blood. Yeah yeah, yeah, I
hear you. So there's a couple of applications at this point.
End the cases are either involved intervention or prevention, and
intervention is when they're trying to prevent further damage from
an incident like a stroke or cardiac arrest or sort
of the two main ones UM and then preventative wise,
(19:17):
it's to extend operating time because back in the day
you could not operate on UM. Well, back in the
day you couldn't stop the heart to operate on it. No,
which was I do remember we did like this day
in history about the first guy to ever do open
heart centuries of Black surgeon in Chicago the early twentieth century,
(19:37):
I think, and he did an emergency open heart surgery
with a beating heart. That guy was totally awesome, champion. UM.
This was the case for a very long time, and
you couldn't stop the heart. They finally invented a machine
UM that basically does the work of the heart and
(19:57):
the lungs, called the Heart Lung machine. Exactly where you're
transferring blood through this machine and UM, it's removing c
O two, it's adding oxygen, and it's pumping it back
into the body while the heart and lungs are stopped.
Revolutionized open heart surgery. There's problems with it. One of
the problems is um when the blood comes back in
(20:19):
the body, since it's been through this machine, it may
have picked up some sort of foreign in bacteria, and
the immune system sometimes mounts an attack on the blood.
So this this machine poses its own problems. And alternatively,
an alternative method for stopping the heart or slowing the
heart is to use medically induced hypothermia. So that's an intervention, no,
(20:43):
a prevention preventative use of medically induced hypothermia. But intervention
is another way, like you said, and it can have
to do a stroke or heart attacks or cardiac arrest. Right,
aren't those two different things? I think so technically, but
in some sort of cessation of the heart pumping blood.
And the big problem with that it doesn't really matter
(21:05):
whether your hand is getting blood for a while. The
big problem that comes from a heart attack is your
brain not getting blood for a while. Right, So here's
what happens when blood stops flowing into your brain. Right,
And we we covered this somehow in the How Dying
Works episode. Yeah, the dying process. Okay, because it's not
(21:26):
a it's not a black and white thing. Uh, you're
not alive and then you're dead. It's comes in many
many stages. And we talked about the stages of death. Yeah,
so there's when what they've discovered is that, yeah, you're
not like I'm alive and now I'm dead. Is what
we covered in the How Dying Works episode? Right, Like
dying in your sleep? I mentioned that the other day.
(21:47):
How like nobody dies in their sleep. That's just a
nice thing. That's a nice way to say they died
in their bed. Yes, overnight, overnight, Yeah, exactly. Um so, yeah,
there's with medically induced hypothermia, they've been able to extend
that that time between when you appear to be dead
and when you're actually dead, and by extending that time
(22:07):
they can intervene UM better. And Yeah, even a little
bit of time can go a long way. So one
of the one of the things that medically induced hypothermia
has been shown to really help is what's called return
of spontaneous circulation after uh, you have a heart attack.
The problem is is your heart and lungs can your
(22:29):
cardio pulmonary system can start working again, but you might
not regain consciousness. And in that case, that's a sign
that your brain may be in trouble, your cognitive function,
you may be suffering brain damage at that moment. Yeah,
And isn't the stat one and ten cardiac arrest outside
of a hospital has a like goes on to live
(22:50):
like a without brain damage. Yeah, ten, only because you
have a very small window and that window is usually
longer than it takes to get to the hospital. Right,
So if they bring you in and you are showing
signs of um r OSC without return to consciousness, too um.
They may induce medical medical hypothermia. And the reason why
(23:10):
is the heart pumps blood, and blood contains things including
oxygen right um. And one of the organs that uses
probably the most oxygen of all, is the brain, and
the brain uses its oxygen to um burn energy. Basically,
it uses it to oxidize glucose. And when it does that,
(23:30):
the reason it does is because you're neurons, your little
neural cells that fire. The way they fire is because
their chemical battery, their chemical battery with the stored potential charge,
and they do that by keeping a lower concentration of
electrolytes inside the cell than outside. So this difference creates
the electrical charge that your neurons used to fire. Right
(23:52):
on normal circumstances, that's all well and good, but when
they stop, when they stop getting oxygen, they can switch
to anaerobic mode for a little while, so they're still
burning energy, but they're like, you need to start breathing again,
because this is not very efficient. It's like the like
when the emergency lights go on exactly exactly. So um.
(24:13):
As a byproduct of anaerobic um respiration, you get the
stuff called lactic acid. Lactic acid in and of itself
isn't bad, but it can build up. One of the
other things that happens to when these um when this uh,
when that runs out, is the difference between electrolytes inside.
Now inside the cell stops like it, it evens out,
(24:35):
and now all of a sudden you have things like calcium, potassium,
sodium coming in and out of the cell as much
as they please, and the cell is like, what is
going on? This isn't good and releases its store of glutamate.
And glutamate is a neurotransmitter that excites neurons, and again
in very small amounts, totally fine, it's needed. But when
(24:55):
a neuron just freaks out and dumps all that into
a synapse, it sets off that neuron and all these
other neurons and makes them go totally crazy, and it
also um lowers their structural integrity. So all of a
sudden you have neurons going nuts, dumping their contents everywhere,
and then creating also free radicals, which are um atoms
(25:16):
with unpaired electrons, and they run up against the cellular
structure and the cell walls and start borrowing electrons from
those atoms, and that weakens the structure even more so,
even more stuff gets dumped out into the inter cellular matrix,
and you have a problem. This is a really big
problem in and of itself. Right, you're still with me, Okay,
(25:36):
that's what happens when you stop getting blood flow. It's
just as bad, if not worse, when you start getting
blood flow again, because you have all these damaged cells.
You have dead cells. And when you have dead cells
that have dumped their contents, one of the roles that
your white blood cells, your immune system plays is to
come clean up dead cells because that's toxic stuff. That's
bad stuff, and you need to get it out of
(25:58):
your body. So when blood flow reach turns again, all
of those white blood cells come to the site of
this problem, your brain, and they start cleaning up. Well.
When they do, and inflammatory reaction happens, and all of
a sudden you have swelling in your brain and the
process gets even worse. So these these um structurally challenged
neurons don't just erupt immediately. They do immediately, but it
(26:22):
can continue for hours and days afterwards. And all of
this happens from a heart attack. But by applying cold
temperatures and bringing hypothermion and somebody you can actually stop
this process. You can stop the glutamate from ever being dumped.
They're finding and so give time basically for your brain
to to rebuild itself in the way it needs to
(26:44):
by lowering that metabolic rate that your your neurons need.
That's what it does for for a heart attack, cardiac arrest.
They're definitely two different things. I looked it up and
someone's gonna say, you guys should do a podcast on
that because you don't know what you're talking about. Right,
it's coming. So probably after that we should take a
little break, huh, I think. So you want to get
(27:05):
some tea, yeah, and uh we'll be back with more
cool stuff. All right, So how is this magic done?
(27:32):
It's pretty easy. Actually, yeah, it's easy in theory. But
there are generally three stages UM for therapeutic hypothermia, and
they are induction, maintenance, and rewarming, and they are all
very carefully monitored and have to be done just right. Uh.
So when they go to cool the patient, um, they
will first thing you'll do is sedate them because shivering. Uh,
(27:55):
shivering is the body's way of trying to stay warm.
Like your body wants to be warm, is going to
do everything it can until you die, like Jack Nicholson
outside the maze and the shining exactly to stay warm. Yeah,
and you can't have a body shivering because number one,
it fights off that hypothermia you're inducing, right. Number two,
that uses a lot of energy, which is what you're
(28:16):
combating right there. You're trying to slow the metabolic right,
not increase it, right, and you want a patient that's
still as well. Like one of the problems I've seen
is the problem with doctors like performing in these conditions
because like stop squirming. Well that too, and they have
to keep the room very cold. It's not like they're
in like an eighty degree room and they're trying to
keep them like everything is cold. So the doctors have
(28:38):
to perform under those circumstances too, so they may shiver themselves.
But to keep the patient from shivering, they just solve
that problem by injecting them with the paralytic exactly, so
now they're nice and still they're cooling down. Uh. The
cheap way to do it, which is um and they're
not doing it because it's cheap, but um ice packs
basically armpits growing chest. They're basically wrapping your legs up
(29:02):
and everything they can with ice packs, and that's just
gonna cool you down pretty quickly. Um. Like you said,
they will sometimes use like catheters or a chilled saline solution.
Those are more invasive and more dangerous. They also work
a lot quicker. Yes, very much. And I think they
want to cool people down pretty quickly too, um, which
(29:24):
is I don't think they want to do the cooling
parts slow. No, And that's a really good point. I'm
glad you brought that up. Especially if you're bringing a
patient's body down, um to a really low temperature, you
have to protect against ice crystals forming in the cells
because that can erupt your cells and that's a whole
set of other problems. Right, So if you bring the
(29:46):
temperature down very quickly, you can prevent ice crystals from forming,
that's right, because they require time to form. Yeah, if
it's so, if it's super fast, they won't they won't form.
That's the impression I have. Okay, So during the maintenance phase,
it's you know exactly how it sounds, are just maintaining
that temperature, keeping a very close eye again, using these
(30:07):
cold water packs or forced cold, forced air blankets and
things like that. Um huh, they sound kind of cool,
the forced cold their blanket that. Yeah, they'd be nice
for these Atlanta summers. Get ahold of one of those. Uh.
And there are a lot of risks along the way.
Arrhythmia is a very big risk. Uh. And electrolytes leaving
(30:29):
like potassium, which is necessary for the heart muscle to
function as it should. Um, so they're they're pumping the
electrolytes back into you because you're losing them. So again
they're just maintaining everything. And then the rewarming part has
to be done very very slow. Uh, otherwise you know,
very bad things can happen. And we're talking um point
(30:52):
to seven to point nine degrees per hour fahrenheit fahrenheit
point one five to point five degrease celsius per hour. Yeah,
those super very slow rewarming process, that's right. But if
you've got a good forced air blanket, you can really
control the warming. You get a good brand, not some
(31:12):
off brand. And again they're not like, oh well if
we um, if we heat the person back up at
point one five degree celsius per hour, then this is
what's going to happen. On a cellular level, like they're
not quite there yet. They just know that that's the
sweet spot for rewarming somebody, So chuck. One of the
(31:34):
really um problematic side effects with rewarming a person is um. Yeah,
they're like, why you start to get gaming while you
were under um is uh blood clots. So when you're
when your blood stops pumping because your metabolic rate is
so low, the blood inside you starts to form clots
(31:57):
thanks to your red blood cells and your platelets and um.
When you warm back up, all of a sudden, you
have clots all over your body. And that's a real
problem that that alone can kill you. And that's part
of the problem with the rewarming process. But it turns
out that investigation into animals that hibernate, they found that
animals have some sort of technique to where their red
(32:20):
blood cells just kind of disappear, and then once the
animal comes out of hibernation, it reappears. They don't even
know where they go, no, but they do know that
they don't get rid of them somehow and then regenerate
some other ones because their reappearance is so fast that
they just think the body somehow absorbs them and then
releases them again. Yeah. And the other really cool thing
(32:42):
and we're kind of into hibernation right now, which we'll
talk about in more detail, but um, white blood cells. Uh,
Hibernators remove white blood cells from their blood and storm
in the lymph nodes and then about an hour and
a half after these animals awake, they reappear. And this
has a couple of functions. One is, when you're an
animal undergoing hibernation, Uh, your immune system is going to
(33:06):
be compromised because as white cells are in storage. Right,
that's a problem. Yeah, it's a problem. But just knowing
that animals can do these neat little tricks with their
platelets and white blood cells, uh, could have like big
effects on us if we can figure that out for ourselves.
Well yes, specifically also chuck, because remember when we were
talking about, um, your your neurons dying. Yeah, and when
(33:29):
you reperfuse, when you bring blood back to the brain again,
one of the things that brings with it is those
white blood cells and they start going on the attack.
So if you can figure out how to take white
blood cells out of the equation, it's going to reduce
things like post warming swelling, which can give you brain
damage itself. Yeah, and you talked about the heart lung machine.
(33:50):
One of the big dangers with that machine is a
septic sepsis. And if you have those uh white blood
cells stripped away, then you're not going to be at
risk for that, right and um, they'll be able to
uh hang on to blood longer. Right now. Blood donations
can only be kept a weak um it goes rank quick, yeah,
(34:12):
and um transplant organs can be UM basically cryo protected
for longer too, which is pretty neat. So uh, I
guess we should talk about hibernation for a minute because
it's one of the neatest things in nature. I think,
uh in torp or basically torpor short periods of hibernation
(34:33):
reduced body temperature and inactivity. And when you link a
bunch of torpors together, that's full on hibernation. So yeah,
it's also like a like hibernation light too, Yeah, you
know what I mean, Like you can you can be
I think a bear inners torpor where it's it wakes
up like every once in a while and eats or
(34:54):
poops or does something. And then there's some animals where
you can just shake them like this and they will
not wake up and they're in full on hibernation. Yeah,
and the animals have to prepare for this. They just
don't go betty by and stay asleep for a long time. First,
they become diabetics basically by gorging on food and becoming obese.
It sounds familiar, uh and um, but it doesn't affect
(35:19):
like humans does. It doesn't make them unhealthy, like their
body knows it's preparation for hibernation, knows what to do
with it exactly. Plus they're probably also eating unprocessed foods too,
which I think makes a difference. Yeah, you know, I
think so. Um, they don't atrophy like humans do. Like
when we lay around in bed, we don't our muscles
will atrophy. Um. Animals can go months and months without moving.
(35:43):
Spectacular spectacular. It also kind of suggests that humans aren't
supposed to hybridate. Yeah. Well, although you know, when they
found some of these frozen people, they start to think
maybe human hibernation isn't such a bad thing. Um. Their
lungs when you hibernate, become covered at the really thick
like mucacy uh deposits um. It basically looks like a
(36:05):
human with asthma, but it's you know, a protective measure. Again. Uh,
they go in their brains kind of um go into
a stage that looks like early Alzheimer's. Again, not a
bad thing, it's just preparation. Uh. And it's weird. I mean,
it looks like animals are almost dying when they're preparing
for hibernation. Well some cases, and sometimes they do, especially
(36:28):
when they're forced to come out of hibernation and then
go back in. Their energy stores aren't aren't built for
that kind of thing, like, so they probably will die
because they'll start to death because it required so much
energy to wake back up again. Or they're also vulnerable
to predators too. Yeah, good point, which makes you wonder, like,
what's the point of hibernation, And the point is, well,
(36:50):
it's they don't have enough energy to go elsewhere when
temperatures get cold, so they just kind of shut down
their metabolic demand when food becomes years. Yeah and um,
for the longest time, we didn't think that any um
uh primates could hibernate until two thousand four when they
found a lemur from Madagascar that could hibernate and uh,
(37:16):
well at least go into the regular torpor hibernation light
still and they said, we share about nine of our
genes with the lemur, and they said it's basically like
our cousin. Yeah, I mean that. The doctor basically said
it would be really remarkable if the ability to hibernate
light within that two that we don't have, So basically
(37:36):
humans may have more of an ability to do this
than we think. It would just have to be medically induced. Well,
you know who demonstrates that very well, Chuck. Who's that?
A man named mitsu take Uchi Koshi. Oh, yeah, we
talked about him. What do we talk about him? And
was it cryogenics episode? It was a long time ago.
I do remember that one. Yeah, that's a good one.
(37:57):
That was a good title. But yeah, I remember this
guy though. For so. He is a Japanese man who,
at age thirty five, was hiking with some friends in
Japan and he decided to turn back by himself to go,
I don't know, get something out of his car, and
he wandered off and apparently in a meadow, um tripped
(38:18):
over a rock and fell and hit his head on
another rock and laid there in exposed to these cold
temperatures on this mountain for twenty four days, and he
was found basically in a state of hibernation. His body
temperature was through the floor and um, he had almost
(38:39):
no pulse. His temperature was seventy one degrees which is
twenty two degrees celsius. That's his body temperature. That's pretty
that's like a hypothermic state. And he was in this
weird kind of state of suspended animation for twenty four days.
He went without food, water, nothing, just laying there um
(39:00):
living in some weird way until he was rescued and
returned to um complete normalcy. Yeah, it's like the lady
the skier who was frozen, not nearly for as long.
But these cases where humans bodies are defying what we
thought they could do, you can give us insight into, like, hey,
how do we manipulate this for good? How do we
use this to get to the stars. Alright, So I
(39:21):
mentioned earlier that NASA was kind of leading the charge
for UM this really cool suspended animation where you're basically
freezing a person like Han Solo um in carbonite. Yeah,
except it's not carbonite. It's not exactly like that, but
it's it's sort of like that. Actually, it's not like
(39:42):
that at all. Right, um And where NASA dropped off,
the U. S. Army picked back up with some funding
because they basically said on the trauma hospitals during wartime
are chaos because you're trying to to save a person.
You're trying to treat their immediate wound, you're trying to
(40:03):
stabilize them, you're trying to make them better, you're trying
to prevent blood loss. It's it's not an easy thing
to do. It's not like mash you know, where they
just make it look super simple. Right, Well, everybody's drunk
on homemade gin. Yeah, so they're thinking, Um, I wonder
what that stuff tasted like I always wondered. But they're
still they seem to like it pretty much pretty well
because they didn't have anything, I know, but they really
(40:24):
seemed to enjoy it well. The way they handled it
was very much like a fine martini. But you know,
it's just like swill. I don't know they were at
it for several years. Yeah, that's true. We'll have to
ask Allan all of the um Man, I'd love to
meet that guy. Oh yeah, one of my heroes. For attention,
Alan all the reach out to us. So Chuck can
meet too, that would be great. My brother met him,
(40:45):
I'm sure he did. Probably gets Christmas cards, phone, No,
but he did get a picture with him, which is
pretty neat. It's nice. Um, So where was I? Oh, yeah,
mash operating rooms. Yeah, because if you're a doctor, even
in a battle field hospital, you're like, I want a
coffee break too, and so to be like, I don't
have time for this guy right now. Freeze him to
(41:07):
have that ability that would be magnificent. Or if you
did have time for the guy, but you literally didn't
have time to fix these horrific wounds that he came
in with, you could also say, freeze him to buy
me some time, and that will let will give you
the time to basically operate on this guy and completely
(41:29):
repair heart or his brain or what have you. Um.
And that's what medically induced hypothermia does. It's just it
buys you time for either the body to heal itself
in ways we don't understand, or for you, the surgeon
to sew somebody up who without hypothermia would just be
a lost cause. Yeah. There's a doctor named Sam Tishrman
(41:51):
from the University of Maryland chirps working with the University
of Pittsburgh. UM, what are they panthers? University of Pittsburgh,
pitt panthers. I think so that sounds right. It does,
we'll go with panthers. Panthers. Uh. If I got that right,
(42:11):
I'm so sorry, Pittsburgh. We'd love you. UM. But he
is working hard to UM basically UH put patients into
severe hypothermia or suspended animation. And they're calling this emergency
preservation and resuscitation. And this is the one that they
haven't yet experimented on humans. They think they're pretty close,
(42:32):
but this is the one where they flushed the body
with freezing cold saline solution UM, which prevents ice from forming. Yeah,
and it's worked on dogs, and I think it works
on dogs. Got work on humans. Well, they did some
experiments on pigs too, because one of the one of
the things they think they can do where it's not
(42:54):
like if you've had a hard cardiac arrest or a stroke,
but again with trauma like a gunshot, you just can't.
And I didn't I never knew this. You can't resuscitate
a person with CPR that's had blood loss due to
trauma it's completely different than cardiac arrest. Why because it's
a close circulatory system has been opened. I have no idea.
I bet that's it. Because of the dropping blood pressure.
(43:15):
It's just not working. It's like sucking through a straw
that has a hole beneath your lips. Like a lot
of it's escaping, A lot of the air's escaping, so
you can't get as much draw. Yeah, I guess that
makes I bet that's what it is. All right, Well
we'll probably find out. Um, but with ellen all with
trauma like a gunshot wound or something, or a stab
wound where you've lost so much blood you're dying. Um.
(43:39):
This is when they're using these super super cold temperatures. Um.
It's a tube inserted into the a orda literally And
they've done this on pigs. In two thousand six, they
examined um deep profound and ultra profound freezing of pigs
who had uncontrolled bleeding wounds. And I imagine and then
(44:01):
imagine they induced those as well. Piggy grad student. Yeah,
there's one creep post doc to get to do you know,
all the stabbings. Um, that's why I'm here. I'll get Ronnie.
Um and they found that the ones who went underwent
the most profound hypothermia had the highest survival rates, like
(44:21):
those French soldiers on the battle exactly. And then in
two thousand they did the same thing with dogs, except
that why they weren't stabbed, it was dogs and cardiac arrest. Um,
they may have induced that too though, come to think
of it, they'd be like, do you want this bone?
Now you can't have it. But they used ice cold
ceiling in that case, and their chances of survival with
(44:43):
no brain damage really increased. So, um, it's you know,
there are risks though it's not the easiest thing to do,
like we said, and um, I know pneumonia was one
of the risks for years, um, even with just the
regular cooling, right. Uh. Yeah, pneumonia slowed heart rate. Apparently
(45:04):
you can enter hyperthermia while you're being rewarmed, Like you
get way too hot, your body temperature increases too dramatically.
There's a lot of problems that. Blood clotting is still
an issue and probably will be for a while. Yeah.
With Tishrmann's case, trying to use humans though, there's a
couple of problems. Um. One is they have to get
consent from a person to undergo an experiment like this,
(45:26):
but you can't give consent when you're wheeled in there
unconscious from a cardiac arrest. So what he's trying to
do is just spread the word, literally, just spread the
word to the citizens in his area that there's this thing,
and if your husband or wife has the cardiac arrest,
ask for the cold treatment where we completely pumped their
(45:47):
blood out and replace it with frozen sailine. Using cold sailine.
It's pretty amazing, it is. And you know, there's a
lot of people who are still very skeptical of the
idea that medically induced hypothermia can actually work, but there's
also a growing body of studies that show that it
does that has a significant impact. Like there were a
couple there were several in two thousand two that really
(46:10):
broke the thing open where it was like, these people
have a twenty five percent chance of recovery without it,
they have a fifty or seventy five percent chance of
recovery with it, And that's really tough to ignore. It's amazing,
amazing stuff into the future, Chuck, let's go. If you
want to know more about medically induced hypothermia. Check out
(46:31):
our podcast page for this episode. It's got a bunch
of cool links and you can type therapeutic hypothermia in
the search part how stuff works dot com and it
will bring up this article of puns. And Uh, since
I said search parts, time for listener mail, I'm gonna
call this um Josh's theory on satire. Remember that we
(46:52):
talked about that in the very recent show Clowns CNN. Uh.
Do you want to summarize your position real quick that
maybe satire is just a release and does it affect change?
Is that the nuts and bolts of it. Yeah, Basically
it lets the populace who's angry let off steam at
the leadership without actually forcing the leadership to change. All right,
(47:13):
So that brings us up to speed. And this is
from Chelsea. Uh. She said, I just started listening under
a year ago when a change in jobs landed me
with a twenty five minute walk to and from work
every day. I think she's in dublin. Um, she says,
I find myself laughing out loud at your repartee. And
my boyfriend is affectionately started referring to you as my
nerd friends. But he's a listener. Now to it sounds
(47:35):
like Dublin I'm actually writing in regard to Josh's theory
on satire. It's a really interesting point, an angle I
had not considered myself. I think though, that there's another
way to look at it, which is that satire has
the ability to plant the seed of dissent in a
non threatening way and thus can eventually be a force
of change. For example, someone may not be aware of
a particular foible of a leader. That satirist points it
(47:57):
out in a funny way. Now that someone has an awareness,
without feeling preached at, and has it in their mind
the next time the leader does something untoward, or perhaps
they were just uh, they were aware of said foible,
but the satirists opened their eyes to just how ridiculous
and or dangerous it is. So while there's certainly a
possibility satire connect as a placation or a way of
(48:17):
letting off steam, there's also a very real possibility that
can spark be the spark that ignites an eventual change.
It is a good point. Yeah, that's from Chelsea and
Morgan Hoffman. Thanks a lot, Chelsea Morgan Hoffman of Dublin, Ireland.
Probably h well, she just said Dublin, Dublin, Georgia. I'm
gonna go ahead and assume Ireland. Yeah, and boyfriend, yes,
thank you both for listening. We appreciate it. Uh. And
(48:40):
if you have a counterpoint, or your own theory or hypothesis,
or just want to say hi or whatever, you can
tweet to us at s y s K podcast. You
can join us on Facebook dot com slash Stuff you
Should Know, UH, you can send us an email to
Stuff Podcast at how Stuff Works dot com, and as always,
joined us at our luxurious home on the web, Stuff
you Should Know dot com. Stuff you Should Know is
(49:05):
a production of I Heart Radio. For more podcasts my
Heart Radio, visit the I Heart Radio app, Apple Podcasts,
or wherever you listen to your favorite shows. H
M Hey everybody, it's Josh and for this week's select,
I've chosen our two thousand fifteen episode on therapeutic hypothermia.
It sounds weird and boring and it's a really super
science EPP. But sometimes sometimes those can be the best ones.
This topic is super interesting. It's a look at how
science can stave off death and hopefully it's the direction
(00:22):
that modern medicine is heading. Plus, if you get bored,
you can thrill the hearing us. Try to say cellular
level here or there. It's hilarious. Enjoy. I command you.
Welcome to Stuff you Should Know, a production of I
Heart Radio. Hey, and welcome to the podcast. I'm Josh Clark.
(00:49):
There's Charles W. Eager Beaver, Chuckers Bryant ready to get
its therapeutic hypothermia on. Yeah, baby, I'm chilling. Yeah, moving
at a glacial paste today, right, I am um, I'm
sorry for that. That was actually a poke at the
author of this article. Yeah, that's uh. That stood out
(01:10):
to me as well. I'm not telling you Jerry's over
there and stuff you should know. No, I'm done. Um. Yeah,
we were goofing off about this article and how stuff works.
That there were way too many cold puns for my liking.
There was a lot of puns, you know, a lot
lots of them. Yeah, this article stinks of punt it reeks.
(01:33):
So how you doing, man, how you feeling? I'm good? Uh,
it seems there's a sickness going around the office. Yeah,
which I thought we knew here in two thousand and
fifteen that if you're sick, you don't come into work,
especially when you have a liberal telecommune policy right like
we do. I realized, Um, I realized that people need
to come in and shoot video and recording all that.
(01:55):
But come in, you do that, and you leave, and
you wear like a plague doctor's mask the whole time
you're here too. Yeah. I mean, I have a biohazard
suit at my desk, but has a RiPP in it.
Anyone can wear it, has a ripping. It's very small
rental and cleaning fee. You're going to take a blood
sample of mine wearing that thing. And it occurred to
(02:17):
me as you were about to put it on, like
I don't know where that thing has been, Like, that's
a real biohazard suit and Chuck's going to use it
to open my skin. Yeah, this sounds very odd. Um,
we don't just do this in the office. We did
our blood Types episode live here in Atlanta, and we
actually took Josh's blood type on stage because you didn't
know it. No, I when we recorded the version in
(02:41):
the studio, I genuinely did not know it. Yeah, so
I took your blood on stage. You trusted me. I
did not wear the contaminated suit. No, you. You just
used your dirty hands with no like rubber gloves or anything.
Look at you. You're fine ish and you know your
blood type now, which was a positive like Jarius, So
(03:03):
we should release that whole live show. Is a just
a special yeah little bonus. Yeah bonus. That was the
word I was looking for. There's something special about it.
It's just a bonus. That was special. Yeah, it's a
good idea. Look for that soon people. So, uh, today, Chuck,
we're talking about therapeutic hypothermia and I am very excited
(03:23):
about this. This is my idea of this article. Yeah, Um,
it's pretty neat. I don't remember. I guess I first
heard of it from that Mosaic article that we both
read to the big sleep awesome article. And uh, if
you haven't figured out by now we have started to
on the podcast page for each episode, put related links
on there on our site stuff you should know dot com,
(03:45):
so that articles on there. There's a bunch of other
stuff on there too that will cover UM. But be
sure to check out that mosaic article. It's very neat
um and that article first introduced me to the concept
of therapeutic hypothermia or medically induced hypothermia as another another
term for it. I don't prefer target targeted temperature management.
(04:07):
That sounds yeah corporate, Yeah, very corporate. You know the
HMO term for it, like we'll we'll call it this
because it'll less than the likelihood that we'll get sued
or something exactly. Yes, yeah, I agree. But it's been
around for a while, and the the idea that exposing
people to lower temperatures to allow for better medical interventions,
(04:29):
which is the whole basis of therapeutic hypothermia UM, has
been around at least since the Napoleonic Wars. Yeah, it's
pretty neat. I was interested to find that out. They
noticed way back when in the eighteen hundreds early eighteen hundreds,
uh that troops in battlefield trauma, wounded soldiers would the
ones who were not kept warm and cozy by the
(04:51):
fire or in their tents, right, they're just left out
on the battlefield and the coals. Yeah, they actually fared better.
And they were like, wait a minute, is uh And
of course they had no idea at the time what
was going on. No, they're like, did you notice that? Yes,
I did notice that the heart well back to our brandy, Yeah,
pretty much. But they did notice that the ones who
were warm did a lot worse than the ones that
were left out in the cold, which is super interesting. Yeah,
(05:13):
But the the real investigation into what was going on
there didn't start until the thirties with a guy named
Dr temple Faye, and he was actually the first guy
to write about using therapeutic hypothermia. I think in n
was the first paper about it. But he was using
it for a full decade or so before then, basically
(05:34):
putting his patients in ice baths, opening the windows to
their room during the winter, and um, just basically using
any means he could to lower the temperature for I
think I think he had he was using in a
traumatic brain injury patients. Yeah, and I'm sure he did
a lot of explaining along the way to family members
that were like, hey, can you close the window and
(05:55):
warm up my husband here? And that. He was like,
all right, you wanted to I think back then too,
he was like, it's the thirties and this guy is
a traumatic brain injury. Really, there's nothing I can do
to make it worse, the prospects worse, So why don't
you just lighten up their family member? So there was
another pioneer in the fifties named Dr Peter safar Um
(06:17):
s A f A R. And he actually began experimenting
around with this in the e er as well, trying
to reduce tissue injury uh and brain image from a
lack of blood flow. Uh. And this was mainly at
the time in like stroke patients, cardiac arrest patients and
what we'll talk more about it. There's all sorts of
well not all sorts. There are several uses like cases
(06:40):
where you would want to use this and UM ranging
from cardiac arrest to like a gunshot wound to I think,
what is the infant situation? Come again, it is called chuck.
It's a type of encephalofy were ummic encephalofy. Yeah, where
your natal basically the blood flow the lack of blood
(07:02):
flow to the brains cut off for whatever reason, like
maybe the umbilical cord gets rappidly on the baby's neck
or what have you. Um, it leads to a swelling
in the brain, and they started using it to medical
the hypothermia to treat that. That's right, And that was
in the fifties, right, Yeah, the fifties and sixties is
(07:23):
when Dr Safar was doing his work. So this this
is all kind of going on on the side and
um experiments into hypothermia had kind of a bad name
thanks to the Nazis, and a little bit also the
Japanese and World War Two. But the Nazis, especially at
Dock how the concentration camp or the death camp there
(07:46):
um experimented using unwilling human subjects. Uh, they experimented on
the effects of hypothermia in people's bodies. They did all
manner of horrible, grizzly, gruesome stuff for they recorded the
data and there was a long debate over the years
over whether that data could be ethically used. And on
(08:07):
one hand, people were saying, no, it's the Nazis. They
used unwilling subjects. Is it amounted to torture in the
name of science, and I just used air air quotes, right.
And then other people said, well, wait a minute, these
people died, um whether and we're whether they wanted to
or not. They were made to be these test subjects
(08:28):
and they gave their lives. We can honor them at
least by using the data that was cold from it. Well,
once they really dug into the data that the Nazis
had accumulated, it was just like rank amateurs performing scientific experiments.
They followed like almost no protocol. They did terrible record
keeping of descriptions of subjects and things like that. So um,
(08:51):
it's almost like you just have to toss it out
because you just can't trust it scientifically the data. But
but the idea that people were exposed forcibly to hypothermic
conditions kind of gave hypothermia a bad name. So these
guys experimenting with the stuff, it was fringe science for
a while. Yeah, and then it started to come into
(09:12):
the mainstream and then everybody said, well, wait a minute,
hypothermia has all these bad side effects. Let's just table
it for now. Yeah. In the in the fifties to
NASA was doing a lot of work during the Space
Race because the idea was and this is really sort
of two parts. There's the the modern day uh cooling
like that's not freezing somebody basically, and then we also
(09:36):
have what's called suspended animation, which we'll get too later.
Those are totally different things, totally different things, but they
follow the same process initially, right yeah, um, well sort of,
I mean the methods are different, but the same idea
basically is to slow the body down, sown the heart rate,
slow down everything, your metabolism. Yeah. Um. But NASA was
doing this because they put a lot of money into
it because they thought two things. One you could protect
(09:58):
astronauts from cosmic rays and the other is basically straight
up alien like we can freeze people on long journeys
into space and then unfreezing when they get there, which
is not just alien. That's a bunch of sci fi movies.
But there was a doctor named James Lovelock back in
(10:19):
the day who was um freezing hamsters until they froze
and then basically until he couldn't hear heartbeat frozen, yeah,
they were clinically dead. Yeah, and then they would he
would put a little, uh, a little hot teaspoon against
their belly and warm him back up, and he found
that they were actually okay, and he was able to
revive them some of them. Well sure, yeah, I'm sure
(10:40):
there were losses along them, but I mean even one
coming back to life and seeming normal again, it is
pretty significant. It's a significant finding, Yeah, because basically the
idea was planted all of a sudden that hypothermia can
kill you or it can preserve you and keep you
from dying in an extreme situation, right, which is kind
(11:02):
of counterintuitive. Like you think of people who undergo hypothermia
or you know, being exposed to extremely cold temperatures, they're dead.
I mean, we've all seen the shining, we know the end. Yeah,
But apparently there's a rule of thumb among the er
physicians and staff that there's no such thing as a
cold dead body. I thought it was measured twice cut once.
(11:26):
It's a little different. That's for the surgeons. Um, No,
there's no such thing as a as a cold dead body.
You're only dead when you're warm and dead, right, Because well,
there's been some some cases throughout the years. The one
that spectacular one. Yeah, this lady um was she with
Norwegian on a boggenhorn. Um, I don't even know what
(11:48):
that is. It's not an oom out, it's a single
circle above that A. That's a it's a very Norwegian. Yeah,
death metal band name totally. Uh So she was skiing
and um, actually I think she was Swedish, but she
was on holiday skiing in Norway. Um fell headfirst into
a frozen stream and was trapped under ice, submerged for
(12:10):
eighty minutes, stopped breathing, heart stopped. Yeah. I mean she
was well known. She didn't drown. They thought she drowned
until they reheated her. Ten days they reheated her and
she was fine, Like weeks and months later she fully recovered.
And basically, if you're underwater warm water, you have a
(12:33):
few minutes at most. But what they discovered was if
you actually go into hypothermia, it can preserve your body. Um,
which was amazing and a big breakthrough into like, hey,
maybe we can use this right. Yeah, she was one
of a few a handful of people and we'll talk
about some others too, but um, that what researchers into
(12:55):
hypothermia I've learned and why they figured out that they're
you're not cold and dead you're just warm. And debt
is that it's not the the the addition of cold
or the exposure to cold that kills you. It's warming
back up in the wrong way too rapidly under the
wrong circumstances stances that that's what can kill you. Yeah,
(13:19):
it seems like it's a very fine line between well,
we'll talk about the process, but you have to do
it just right on the cooling side and the warming
side if you want to be successful right exactly. You know,
it's they haven't quite figured it all out yet. This
is in the very uh nascent stages. Still. It is
ridiculously primitive and and to the point where it's kind
(13:40):
of like if you're a doctor experimenting with this, you
you would be like, there's a d chance that your
dad is going to die under normal circumstances. We have
this one radical technique we can try that might help.
Can we try this? And that that that whether they
had lives or dies after being given medical hypothermia, he's
(14:04):
still going to end up as like the subject of
a major paper that would be written, because that's where
it's at right now. Yeah, And I read one doctor
said that they they think they pretty much know, it's
super possible and we'll work, he said, But it's the
the doing of it that's just really really hard. Exactly. Yeah,
I mean like it makes a complete sense intuitively, we
(14:25):
understand like what it's doing. It's just yeah, the fine tuning,
the nuance behind it that it's still kind of mysterious.
The most brilliant doctors say, it's just really hard. He said,
it's really dog gone hard to do. It kind of
makes you go, yeah, you know, is that the quote?
He know, his quote was, it's really dog gone hard.
And then my quote was, but we'll talk about medical
(14:48):
hypothermia and what it is specifically, uh, in just a
minu alright, so therapeutic hypothermia. Hypothermia is basically when you
(15:17):
lower the body temperature for various reasons to keep it alive.
And right now, what they're mainly doing now, this isn't
the second wave, which is freezing somebody. This is just
cooling a body before and after surgery to help them
increase their chances of survival. Basically, right, your your body. Um,
(15:41):
and they're doing that now on this side, they're just
not doing the other quite yet on humans. Yes, um,
so under normal circumstances, your body maintains a normal core
body temperature, normative temperature because what it's called, right, and um,
that's somewhere between like nineties in nine point six degrees
(16:02):
is a normal human core body temperature. And all of
this is and dude, do you remember and like when
I went on that crazy, weird metaphysical tangent and does
the body replace itself? Somebody wrote in and said, check
this article out, like here's a really great explanation of
why things live, where life comes from. And it was this, um,
(16:24):
this idea, it's a physics based idea of life and evolution.
And it says that because of entropy, because of one
of the laws of thermodynamics, that atoms will arrange themselves
in a way that they can take in energy and
dissipate heat in a really efficient manner. And so of
course they're gonna atoms are eventually going to arrange themselves
(16:46):
into life. It just makes total sense. Right, So, being
living things like we are, we take in energy and
we dissipate heat, and that's what forms our core body temperature. Right.
With therapeutic hype of thermia, what you're doing is lowering
the metabolic rate through the addition of cold, and so
(17:08):
we put out less heat, and by doing that, we're
also lowering our energy demand, so that that that little
engine that's going all the time and our cells and
our body in general gets slowed down. And it's not
altered in any way except for the speed and the
energy consumption. It's just slowed down. It's doing everything slower.
(17:30):
And you can do that simply by lowering the temperature
of the person. Yeah, and it's it's not just lower,
it's um it doesn't need to be faster. Does that
make sense, Like the heart beat slower because it doesn't
need to beat any faster, not like your body is struggling.
Your body is still doing fine. It's just reducing the
(17:50):
demand for stuff like blood flow and neurotransmitter action and
stuff like that exactly. And ultimately, what your heart does
is pumps blood. And what your blood has this, among
other things, oxygen, and your cells need oxygen to carry
out these metabolic processes to burn energy, right, So if
they need less, then your heart doesn't have to beat
(18:11):
as much. It's like you said, it's just the normal processes,
but on a much slower scale. Pretty awesome stuff. It is,
and it's just through the application of colder temperatures. Oh yeah,
and in this case UM, and we'll get to how
to do it. But in this case you're not I
mean you're literally cooling the body with like ice packs
and cold blankets and stuff like that pre surgery and
(18:33):
post surgery. It's not the suspended animation one that we'll
get to when they're actually like pumping frozen saline through
your pains. No, there are, but there are some UM
techniques for medically induced hypothermia that do put in like
chilled saline to chill your body down very quickly. But
(18:53):
it's not like replacing your blood. Yeah yeah, yeah, I
hear you. So there's a couple of applications at this point.
End the cases are either involved intervention or prevention, and
intervention is when they're trying to prevent further damage from
an incident like a stroke or cardiac arrest or sort
of the two main ones UM and then preventative wise,
(19:17):
it's to extend operating time because back in the day
you could not operate on UM. Well, back in the
day you couldn't stop the heart to operate on it. No,
which was I do remember we did like this day
in history about the first guy to ever do open
heart centuries of Black surgeon in Chicago the early twentieth century,
(19:37):
I think, and he did an emergency open heart surgery
with a beating heart. That guy was totally awesome, champion. UM.
This was the case for a very long time, and
you couldn't stop the heart. They finally invented a machine
UM that basically does the work of the heart and
(19:57):
the lungs, called the Heart Lung machine. Exactly where you're
transferring blood through this machine and UM, it's removing c
O two, it's adding oxygen, and it's pumping it back
into the body while the heart and lungs are stopped.
Revolutionized open heart surgery. There's problems with it. One of
the problems is um when the blood comes back in
(20:19):
the body, since it's been through this machine, it may
have picked up some sort of foreign in bacteria, and
the immune system sometimes mounts an attack on the blood.
So this this machine poses its own problems. And alternatively,
an alternative method for stopping the heart or slowing the
heart is to use medically induced hypothermia. So that's an intervention, no,
(20:43):
a prevention preventative use of medically induced hypothermia. But intervention
is another way, like you said, and it can have
to do a stroke or heart attacks or cardiac arrest. Right,
aren't those two different things? I think so technically, but
in some sort of cessation of the heart pumping blood.
And the big problem with that it doesn't really matter
(21:05):
whether your hand is getting blood for a while. The
big problem that comes from a heart attack is your
brain not getting blood for a while. Right, So here's
what happens when blood stops flowing into your brain. Right,
And we we covered this somehow in the How Dying
Works episode. Yeah, the dying process. Okay, because it's not
(21:26):
a it's not a black and white thing. Uh, you're
not alive and then you're dead. It's comes in many
many stages. And we talked about the stages of death. Yeah,
so there's when what they've discovered is that, yeah, you're
not like I'm alive and now I'm dead. Is what
we covered in the How Dying Works episode? Right, Like
dying in your sleep? I mentioned that the other day.
(21:47):
How like nobody dies in their sleep. That's just a
nice thing. That's a nice way to say they died
in their bed. Yes, overnight, overnight, Yeah, exactly. Um so, yeah,
there's with medically induced hypothermia, they've been able to extend
that that time between when you appear to be dead
and when you're actually dead, and by extending that time
(22:07):
they can intervene UM better. And Yeah, even a little
bit of time can go a long way. So one
of the one of the things that medically induced hypothermia
has been shown to really help is what's called return
of spontaneous circulation after uh, you have a heart attack.
The problem is is your heart and lungs can your
(22:29):
cardio pulmonary system can start working again, but you might
not regain consciousness. And in that case, that's a sign
that your brain may be in trouble, your cognitive function,
you may be suffering brain damage at that moment. Yeah,
And isn't the stat one and ten cardiac arrest outside
of a hospital has a like goes on to live
(22:50):
like a without brain damage. Yeah, ten, only because you
have a very small window and that window is usually
longer than it takes to get to the hospital. Right,
So if they bring you in and you are showing
signs of um r OSC without return to consciousness, too um.
They may induce medical medical hypothermia. And the reason why
(23:10):
is the heart pumps blood, and blood contains things including
oxygen right um. And one of the organs that uses
probably the most oxygen of all, is the brain, and
the brain uses its oxygen to um burn energy. Basically,
it uses it to oxidize glucose. And when it does that,
(23:30):
the reason it does is because you're neurons, your little
neural cells that fire. The way they fire is because
their chemical battery, their chemical battery with the stored potential charge,
and they do that by keeping a lower concentration of
electrolytes inside the cell than outside. So this difference creates
the electrical charge that your neurons used to fire. Right
(23:52):
on normal circumstances, that's all well and good, but when
they stop, when they stop getting oxygen, they can switch
to anaerobic mode for a little while, so they're still
burning energy, but they're like, you need to start breathing again,
because this is not very efficient. It's like the like
when the emergency lights go on exactly exactly. So um.
(24:13):
As a byproduct of anaerobic um respiration, you get the
stuff called lactic acid. Lactic acid in and of itself
isn't bad, but it can build up. One of the
other things that happens to when these um when this uh,
when that runs out, is the difference between electrolytes inside.
Now inside the cell stops like it, it evens out,
(24:35):
and now all of a sudden you have things like calcium, potassium,
sodium coming in and out of the cell as much
as they please, and the cell is like, what is
going on? This isn't good and releases its store of glutamate.
And glutamate is a neurotransmitter that excites neurons, and again
in very small amounts, totally fine, it's needed. But when
(24:55):
a neuron just freaks out and dumps all that into
a synapse, it sets off that neuron and all these
other neurons and makes them go totally crazy, and it
also um lowers their structural integrity. So all of a
sudden you have neurons going nuts, dumping their contents everywhere,
and then creating also free radicals, which are um atoms
(25:16):
with unpaired electrons, and they run up against the cellular
structure and the cell walls and start borrowing electrons from
those atoms, and that weakens the structure even more so,
even more stuff gets dumped out into the inter cellular matrix,
and you have a problem. This is a really big
problem in and of itself. Right, you're still with me, Okay,
(25:36):
that's what happens when you stop getting blood flow. It's
just as bad, if not worse, when you start getting
blood flow again, because you have all these damaged cells.
You have dead cells. And when you have dead cells
that have dumped their contents, one of the roles that
your white blood cells, your immune system plays is to
come clean up dead cells because that's toxic stuff. That's
bad stuff, and you need to get it out of
(25:58):
your body. So when blood flow reach turns again, all
of those white blood cells come to the site of
this problem, your brain, and they start cleaning up. Well.
When they do, and inflammatory reaction happens, and all of
a sudden you have swelling in your brain and the
process gets even worse. So these these um structurally challenged
neurons don't just erupt immediately. They do immediately, but it
(26:22):
can continue for hours and days afterwards. And all of
this happens from a heart attack. But by applying cold
temperatures and bringing hypothermion and somebody you can actually stop
this process. You can stop the glutamate from ever being dumped.
They're finding and so give time basically for your brain
to to rebuild itself in the way it needs to
(26:44):
by lowering that metabolic rate that your your neurons need.
That's what it does for for a heart attack, cardiac arrest.
They're definitely two different things. I looked it up and
someone's gonna say, you guys should do a podcast on
that because you don't know what you're talking about. Right,
it's coming. So probably after that we should take a
little break, huh, I think. So you want to get
(27:05):
some tea, yeah, and uh we'll be back with more
cool stuff. All right, So how is this magic done?
(27:32):
It's pretty easy. Actually, yeah, it's easy in theory. But
there are generally three stages UM for therapeutic hypothermia, and
they are induction, maintenance, and rewarming, and they are all
very carefully monitored and have to be done just right. Uh.
So when they go to cool the patient, um, they
will first thing you'll do is sedate them because shivering. Uh,
(27:55):
shivering is the body's way of trying to stay warm.
Like your body wants to be warm, is going to
do everything it can until you die, like Jack Nicholson
outside the maze and the shining exactly to stay warm. Yeah,
and you can't have a body shivering because number one,
it fights off that hypothermia you're inducing, right. Number two,
that uses a lot of energy, which is what you're
(28:16):
combating right there. You're trying to slow the metabolic right,
not increase it, right, and you want a patient that's
still as well. Like one of the problems I've seen
is the problem with doctors like performing in these conditions
because like stop squirming. Well that too, and they have
to keep the room very cold. It's not like they're
in like an eighty degree room and they're trying to
keep them like everything is cold. So the doctors have
(28:38):
to perform under those circumstances too, so they may shiver themselves.
But to keep the patient from shivering, they just solve
that problem by injecting them with the paralytic exactly, so
now they're nice and still they're cooling down. Uh. The
cheap way to do it, which is um and they're
not doing it because it's cheap, but um ice packs
basically armpits growing chest. They're basically wrapping your legs up
(29:02):
and everything they can with ice packs, and that's just
gonna cool you down pretty quickly. Um. Like you said,
they will sometimes use like catheters or a chilled saline solution.
Those are more invasive and more dangerous. They also work
a lot quicker. Yes, very much. And I think they
want to cool people down pretty quickly too, um, which
(29:24):
is I don't think they want to do the cooling
parts slow. No, And that's a really good point. I'm
glad you brought that up. Especially if you're bringing a
patient's body down, um to a really low temperature, you
have to protect against ice crystals forming in the cells
because that can erupt your cells and that's a whole
set of other problems. Right, So if you bring the
(29:46):
temperature down very quickly, you can prevent ice crystals from forming,
that's right, because they require time to form. Yeah, if
it's so, if it's super fast, they won't they won't form.
That's the impression I have. Okay, So during the maintenance phase,
it's you know exactly how it sounds, are just maintaining
that temperature, keeping a very close eye again, using these
(30:07):
cold water packs or forced cold, forced air blankets and
things like that. Um huh, they sound kind of cool,
the forced cold their blanket that. Yeah, they'd be nice
for these Atlanta summers. Get ahold of one of those. Uh.
And there are a lot of risks along the way.
Arrhythmia is a very big risk. Uh. And electrolytes leaving
(30:29):
like potassium, which is necessary for the heart muscle to
function as it should. Um, so they're they're pumping the
electrolytes back into you because you're losing them. So again
they're just maintaining everything. And then the rewarming part has
to be done very very slow. Uh, otherwise you know,
very bad things can happen. And we're talking um point
(30:52):
to seven to point nine degrees per hour fahrenheit fahrenheit
point one five to point five degrease celsius per hour. Yeah,
those super very slow rewarming process, that's right. But if
you've got a good forced air blanket, you can really
control the warming. You get a good brand, not some
(31:12):
off brand. And again they're not like, oh well if
we um, if we heat the person back up at
point one five degree celsius per hour, then this is
what's going to happen. On a cellular level, like they're
not quite there yet. They just know that that's the
sweet spot for rewarming somebody, So chuck. One of the
(31:34):
really um problematic side effects with rewarming a person is um. Yeah,
they're like, why you start to get gaming while you
were under um is uh blood clots. So when you're
when your blood stops pumping because your metabolic rate is
so low, the blood inside you starts to form clots
(31:57):
thanks to your red blood cells and your platelets and um.
When you warm back up, all of a sudden, you
have clots all over your body. And that's a real
problem that that alone can kill you. And that's part
of the problem with the rewarming process. But it turns
out that investigation into animals that hibernate, they found that
animals have some sort of technique to where their red
(32:20):
blood cells just kind of disappear, and then once the
animal comes out of hibernation, it reappears. They don't even
know where they go, no, but they do know that
they don't get rid of them somehow and then regenerate
some other ones because their reappearance is so fast that
they just think the body somehow absorbs them and then
releases them again. Yeah. And the other really cool thing
(32:42):
and we're kind of into hibernation right now, which we'll
talk about in more detail, but um, white blood cells. Uh,
Hibernators remove white blood cells from their blood and storm
in the lymph nodes and then about an hour and
a half after these animals awake, they reappear. And this
has a couple of functions. One is, when you're an
animal undergoing hibernation, Uh, your immune system is going to
(33:06):
be compromised because as white cells are in storage. Right,
that's a problem. Yeah, it's a problem. But just knowing
that animals can do these neat little tricks with their
platelets and white blood cells, uh, could have like big
effects on us if we can figure that out for ourselves.
Well yes, specifically also chuck, because remember when we were
talking about, um, your your neurons dying. Yeah, and when
(33:29):
you reperfuse, when you bring blood back to the brain again,
one of the things that brings with it is those
white blood cells and they start going on the attack.
So if you can figure out how to take white
blood cells out of the equation, it's going to reduce
things like post warming swelling, which can give you brain
damage itself. Yeah, and you talked about the heart lung machine.
(33:50):
One of the big dangers with that machine is a
septic sepsis. And if you have those uh white blood
cells stripped away, then you're not going to be at
risk for that, right and um, they'll be able to
uh hang on to blood longer. Right now. Blood donations
can only be kept a weak um it goes rank quick, yeah,
(34:12):
and um transplant organs can be UM basically cryo protected
for longer too, which is pretty neat. So uh, I
guess we should talk about hibernation for a minute because
it's one of the neatest things in nature. I think,
uh in torp or basically torpor short periods of hibernation
(34:33):
reduced body temperature and inactivity. And when you link a
bunch of torpors together, that's full on hibernation. So yeah,
it's also like a like hibernation light too, Yeah, you
know what I mean, Like you can you can be
I think a bear inners torpor where it's it wakes
up like every once in a while and eats or
(34:54):
poops or does something. And then there's some animals where
you can just shake them like this and they will
not wake up and they're in full on hibernation. Yeah,
and the animals have to prepare for this. They just
don't go betty by and stay asleep for a long time. First,
they become diabetics basically by gorging on food and becoming obese.
It sounds familiar, uh and um, but it doesn't affect
(35:19):
like humans does. It doesn't make them unhealthy, like their
body knows it's preparation for hibernation, knows what to do
with it exactly. Plus they're probably also eating unprocessed foods too,
which I think makes a difference. Yeah, you know, I
think so. Um, they don't atrophy like humans do. Like
when we lay around in bed, we don't our muscles
will atrophy. Um. Animals can go months and months without moving.
(35:43):
Spectacular spectacular. It also kind of suggests that humans aren't
supposed to hybridate. Yeah. Well, although you know, when they
found some of these frozen people, they start to think
maybe human hibernation isn't such a bad thing. Um. Their
lungs when you hibernate, become covered at the really thick
like mucacy uh deposits um. It basically looks like a
(36:05):
human with asthma, but it's you know, a protective measure. Again. Uh,
they go in their brains kind of um go into
a stage that looks like early Alzheimer's. Again, not a
bad thing, it's just preparation. Uh. And it's weird. I mean,
it looks like animals are almost dying when they're preparing
for hibernation. Well some cases, and sometimes they do, especially
(36:28):
when they're forced to come out of hibernation and then
go back in. Their energy stores aren't aren't built for
that kind of thing, like, so they probably will die
because they'll start to death because it required so much
energy to wake back up again. Or they're also vulnerable
to predators too. Yeah, good point, which makes you wonder, like,
what's the point of hibernation, And the point is, well,
(36:50):
it's they don't have enough energy to go elsewhere when
temperatures get cold, so they just kind of shut down
their metabolic demand when food becomes years. Yeah and um,
for the longest time, we didn't think that any um
uh primates could hibernate until two thousand four when they
found a lemur from Madagascar that could hibernate and uh,
(37:16):
well at least go into the regular torpor hibernation light
still and they said, we share about nine of our
genes with the lemur, and they said it's basically like
our cousin. Yeah, I mean that. The doctor basically said
it would be really remarkable if the ability to hibernate
light within that two that we don't have, So basically
(37:36):
humans may have more of an ability to do this
than we think. It would just have to be medically induced. Well,
you know who demonstrates that very well, Chuck. Who's that?
A man named mitsu take Uchi Koshi. Oh, yeah, we
talked about him. What do we talk about him? And
was it cryogenics episode? It was a long time ago.
I do remember that one. Yeah, that's a good one.
(37:57):
That was a good title. But yeah, I remember this
guy though. For so. He is a Japanese man who,
at age thirty five, was hiking with some friends in
Japan and he decided to turn back by himself to go,
I don't know, get something out of his car, and
he wandered off and apparently in a meadow, um tripped
(38:18):
over a rock and fell and hit his head on
another rock and laid there in exposed to these cold
temperatures on this mountain for twenty four days, and he
was found basically in a state of hibernation. His body
temperature was through the floor and um, he had almost
(38:39):
no pulse. His temperature was seventy one degrees which is
twenty two degrees celsius. That's his body temperature. That's pretty
that's like a hypothermic state. And he was in this
weird kind of state of suspended animation for twenty four days.
He went without food, water, nothing, just laying there um
(39:00):
living in some weird way until he was rescued and
returned to um complete normalcy. Yeah, it's like the lady
the skier who was frozen, not nearly for as long.
But these cases where humans bodies are defying what we
thought they could do, you can give us insight into, like, hey,
how do we manipulate this for good? How do we
use this to get to the stars. Alright, So I
(39:21):
mentioned earlier that NASA was kind of leading the charge
for UM this really cool suspended animation where you're basically
freezing a person like Han Solo um in carbonite. Yeah,
except it's not carbonite. It's not exactly like that, but
it's it's sort of like that. Actually, it's not like
(39:42):
that at all. Right, um And where NASA dropped off,
the U. S. Army picked back up with some funding
because they basically said on the trauma hospitals during wartime
are chaos because you're trying to to save a person.
You're trying to treat their immediate wound, you're trying to
(40:03):
stabilize them, you're trying to make them better, you're trying
to prevent blood loss. It's it's not an easy thing
to do. It's not like mash you know, where they
just make it look super simple. Right, Well, everybody's drunk
on homemade gin. Yeah, so they're thinking, Um, I wonder
what that stuff tasted like I always wondered. But they're
still they seem to like it pretty much pretty well
because they didn't have anything, I know, but they really
(40:24):
seemed to enjoy it well. The way they handled it
was very much like a fine martini. But you know,
it's just like swill. I don't know they were at
it for several years. Yeah, that's true. We'll have to
ask Allan all of the um Man, I'd love to
meet that guy. Oh yeah, one of my heroes. For attention,
Alan all the reach out to us. So Chuck can
meet too, that would be great. My brother met him,
(40:45):
I'm sure he did. Probably gets Christmas cards, phone, No,
but he did get a picture with him, which is
pretty neat. It's nice. Um, So where was I? Oh, yeah,
mash operating rooms. Yeah, because if you're a doctor, even
in a battle field hospital, you're like, I want a
coffee break too, and so to be like, I don't
have time for this guy right now. Freeze him to
(41:07):
have that ability that would be magnificent. Or if you
did have time for the guy, but you literally didn't
have time to fix these horrific wounds that he came
in with, you could also say, freeze him to buy
me some time, and that will let will give you
the time to basically operate on this guy and completely
(41:29):
repair heart or his brain or what have you. Um.
And that's what medically induced hypothermia does. It's just it
buys you time for either the body to heal itself
in ways we don't understand, or for you, the surgeon
to sew somebody up who without hypothermia would just be
a lost cause. Yeah. There's a doctor named Sam Tishrman
(41:51):
from the University of Maryland chirps working with the University
of Pittsburgh. UM, what are they panthers? University of Pittsburgh,
pitt panthers. I think so that sounds right. It does,
we'll go with panthers. Panthers. Uh. If I got that right,
(42:11):
I'm so sorry, Pittsburgh. We'd love you. UM. But he
is working hard to UM basically UH put patients into
severe hypothermia or suspended animation. And they're calling this emergency
preservation and resuscitation. And this is the one that they
haven't yet experimented on humans. They think they're pretty close,
(42:32):
but this is the one where they flushed the body
with freezing cold saline solution UM, which prevents ice from forming. Yeah,
and it's worked on dogs, and I think it works
on dogs. Got work on humans. Well, they did some
experiments on pigs too, because one of the one of
the things they think they can do where it's not
(42:54):
like if you've had a hard cardiac arrest or a stroke,
but again with trauma like a gunshot, you just can't.
And I didn't I never knew this. You can't resuscitate
a person with CPR that's had blood loss due to
trauma it's completely different than cardiac arrest. Why because it's
a close circulatory system has been opened. I have no idea.
I bet that's it. Because of the dropping blood pressure.
(43:15):
It's just not working. It's like sucking through a straw
that has a hole beneath your lips. Like a lot
of it's escaping, A lot of the air's escaping, so
you can't get as much draw. Yeah, I guess that
makes I bet that's what it is. All right, Well
we'll probably find out. Um, but with ellen all with
trauma like a gunshot wound or something, or a stab
wound where you've lost so much blood you're dying. Um.
(43:39):
This is when they're using these super super cold temperatures. Um.
It's a tube inserted into the a orda literally And
they've done this on pigs. In two thousand six, they
examined um deep profound and ultra profound freezing of pigs
who had uncontrolled bleeding wounds. And I imagine and then
(44:01):
imagine they induced those as well. Piggy grad student. Yeah,
there's one creep post doc to get to do you know,
all the stabbings. Um, that's why I'm here. I'll get Ronnie.
Um and they found that the ones who went underwent
the most profound hypothermia had the highest survival rates, like
(44:21):
those French soldiers on the battle exactly. And then in
two thousand they did the same thing with dogs, except
that why they weren't stabbed, it was dogs and cardiac arrest. Um,
they may have induced that too though, come to think
of it, they'd be like, do you want this bone?
Now you can't have it. But they used ice cold
ceiling in that case, and their chances of survival with
(44:43):
no brain damage really increased. So, um, it's you know,
there are risks though it's not the easiest thing to do,
like we said, and um, I know pneumonia was one
of the risks for years, um, even with just the
regular cooling, right. Uh. Yeah, pneumonia slowed heart rate. Apparently
(45:04):
you can enter hyperthermia while you're being rewarmed, Like you
get way too hot, your body temperature increases too dramatically.
There's a lot of problems that. Blood clotting is still
an issue and probably will be for a while. Yeah.
With Tishrmann's case, trying to use humans though, there's a
couple of problems. Um. One is they have to get
consent from a person to undergo an experiment like this,
(45:26):
but you can't give consent when you're wheeled in there
unconscious from a cardiac arrest. So what he's trying to
do is just spread the word, literally, just spread the
word to the citizens in his area that there's this thing,
and if your husband or wife has the cardiac arrest,
ask for the cold treatment where we completely pumped their
(45:47):
blood out and replace it with frozen sailine. Using cold sailine.
It's pretty amazing, it is. And you know, there's a
lot of people who are still very skeptical of the
idea that medically induced hypothermia can actually work, but there's
also a growing body of studies that show that it
does that has a significant impact. Like there were a
couple there were several in two thousand two that really
(46:10):
broke the thing open where it was like, these people
have a twenty five percent chance of recovery without it,
they have a fifty or seventy five percent chance of
recovery with it, And that's really tough to ignore. It's amazing,
amazing stuff into the future, Chuck, let's go. If you
want to know more about medically induced hypothermia. Check out
(46:31):
our podcast page for this episode. It's got a bunch
of cool links and you can type therapeutic hypothermia in
the search part how stuff works dot com and it
will bring up this article of puns. And Uh, since
I said search parts, time for listener mail, I'm gonna
call this um Josh's theory on satire. Remember that we
(46:52):
talked about that in the very recent show Clowns CNN. Uh.
Do you want to summarize your position real quick that
maybe satire is just a release and does it affect change?
Is that the nuts and bolts of it. Yeah, Basically
it lets the populace who's angry let off steam at
the leadership without actually forcing the leadership to change. All right,
(47:13):
So that brings us up to speed. And this is
from Chelsea. Uh. She said, I just started listening under
a year ago when a change in jobs landed me
with a twenty five minute walk to and from work
every day. I think she's in dublin. Um, she says,
I find myself laughing out loud at your repartee. And
my boyfriend is affectionately started referring to you as my
nerd friends. But he's a listener. Now to it sounds
(47:35):
like Dublin I'm actually writing in regard to Josh's theory
on satire. It's a really interesting point, an angle I
had not considered myself. I think though, that there's another
way to look at it, which is that satire has
the ability to plant the seed of dissent in a
non threatening way and thus can eventually be a force
of change. For example, someone may not be aware of
a particular foible of a leader. That satirist points it
(47:57):
out in a funny way. Now that someone has an awareness,
without feeling preached at, and has it in their mind
the next time the leader does something untoward, or perhaps
they were just uh, they were aware of said foible,
but the satirists opened their eyes to just how ridiculous
and or dangerous it is. So while there's certainly a
possibility satire connect as a placation or a way of
(48:17):
letting off steam, there's also a very real possibility that
can spark be the spark that ignites an eventual change.
It is a good point. Yeah, that's from Chelsea and
Morgan Hoffman. Thanks a lot, Chelsea Morgan Hoffman of Dublin, Ireland.
Probably h well, she just said Dublin, Dublin, Georgia. I'm
gonna go ahead and assume Ireland. Yeah, and boyfriend, yes,
thank you both for listening. We appreciate it. Uh. And
(48:40):
if you have a counterpoint, or your own theory or hypothesis,
or just want to say hi or whatever, you can
tweet to us at s y s K podcast. You
can join us on Facebook dot com slash Stuff you
Should Know, UH, you can send us an email to
Stuff Podcast at how Stuff Works dot com, and as always,
joined us at our luxurious home on the web, Stuff
you Should Know dot com. Stuff you Should Know is
(49:05):
a production of I Heart Radio. For more podcasts my
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If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
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