What does it mean to be dead? Scientifically, the best definition of death is the cessation of all biological functions that sustain a living organism. However, nature always seems to find a way to blur the lines. In 1999, a 29-year-old Swedish woman was skiing in Norway when she fell through a crack in a frozen river. She was trapped under the ice for 80 minutes, her body temperature fell to 57°F, and when rescuers found her, she was clinically dead. She stayed that way for 9 hours, but when she began to warm up, her heart started beating again. When she woke, she showed no signs of permanent damage and made a full recovery. The woman experienced something called “suspended animation.” She wasn’t breathing, she didn’t have a heartbeat, and there was no activity in her brain, but she wasn’t dead. The woman was temporarily suspended in a state between life and death. Her biological life processes had significantly slowed down, and may have even stopped completely.
Suspended animation is a term that is almost always paired with science fiction, but today it’s an undeniable reality and researchers are even at the point of beginning trials on human patients for the purpose of literally “buying time” during life-saving procedures. According to a report in New Scientist, surgeons at UPMC Presbyterian Hospital in Pittsburgh are now on call to perform suspended animation operations for critically wounded patients. “If a patient comes to us two hours after dying you can’t bring them back to life,” says surgeon Peter Rhee at the University of Arizona in Tucson, who helped develop the technique. “But if they’re dying and you suspend them, you have a chance to bring them back after their structural problems have been fixed.”
In order to suspend a person between life and death, all of the patient’s blood is replaced with a cold saline solution that rapidly cools the body and halts almost all cellular activity. When the body is cooled, otherwise known as induced hypothermia, almost no metabolic reactions occur in the body, so cells are able to survive without oxygen. Being in this limbo, where a person is not alive, but not yet dead, could give doctors more time during surgeries for life-threatening injuries.
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The technique was first tested on 40 pigs in 2000 by Rhee and his team. The pigs were sedated and inflicted with a lethal wound to simulate real-world trauma scenarios. Their blood was drained and replaced with either a cold potassium or saline solution, and once the animals reached a state of suspended animation, they were treated for their injuries. Ninety percent of the pigs survived and none of them sustained any cognitive or physical impairment. “After we did those experiments, the definition of ‘dead’ changed,” says Rhee. “Every day at work I declare people dead. They have no signs of life, no heartbeat, no brain activity. I sign a piece of paper knowing in my heart that they are not actually dead. I could, right then and there, suspend them. But I have to put them in a body bag. It’s frustrating to know there’s a solution.”
As of March 29, 2014, doctors have been on call to perform life-saving surgeries on patients who qualify for suspended animation. All they have to do now is wait for the right patient to arrive. In order to qualify, patients must have suffered cardiac arrest after a traumatic injury and must not respond to attempts to restart their heart. Currently, doctors only have 2 hours to perform surgery on a patient in suspended animation, but it’s likely that the time window will increase in the future as the technique is mastered. The procedure will be tested on 10 people and their outcomes compared with another 10 who met the criteria, but who weren’t treated while suspended because the team was not on hand.
Because the procedure is performed during a medical emergency, neither the patient nor their family is able to give consent. The FDA is only allowing suspended animation trials to go forward because it considers them to be exempt from informed consent on account of them involving patients whose injures are likely to be fatal with no alternative treatment. However, the hospital is allowing people to opt out of the procedure online, but so far, no one has.
Reference
- Kotler S. Suspended animation goes primetime: say goodbye to death as we know it. Forbes website. May 21, 2014. http://www.forbes.com/sites/stevenkotler/2014/05/21/suspended-animation-goes-primetime-say-goodbye-to-death-as-we-know-it.
- Levin D. Suspended animation. PBS website. January 20, 2011. http://www.pbs.org/wgbh/nova/body/suspended-animation-au.html.
- Thomson H. Gunshot victims to be suspended between life and death. New Scientist website. March 26, 2014. http://www.newscientist.com/article/mg22129623.000-gunshot-victims-to-be-suspended-between-life-and-death.html#.U81GYpRdXeA.
