Real Life Suspended Animation: Dead or Alive?

Healthcare in America has come a long way over the last hundred years. Medical innovation and cutting-edge technology have allowed the standard of care to continuously rise, but is a plateau in our future? Many critics of the Affordable Care Act postulated that the enhanced regulatory burden would disincentivize physicians from pursuing technological and medical innovations that might improve care. Venture-capital investment in medical technology seems to be falling fast, though it is unclear if this is related to the ACA. Logically, price control aims to eliminate wastefulness; while some innovation may be wasteful, a lot of it helps us live longer and healthier lives.

The University of Pittsburgh Medical Center is proving these critics wrong with a new clinic trial in progress that could revolutionize trauma care. The Emergency Preservation and Resuscitation for Cardiac Arrest from Trauma (EPR-CAT) Study, which officially began in April, focuses on patients who arrive at the ER under cardiac arrest with massive trauma from a gunshot or stab wound. Doctors induce therapeutic hypothermia and slow the patient’s metabolism by flushing his blood with freezing saline through a cannula in the aorta, bringing the body temperature below 50°F. This allows the surgeons to “buy time” to control bleeding and mend the patient’s wounds while he has no heartbeat, brain activity, or vital signs; when he is clinically dead. The anticipated outcome is survival to hospital discharge with minimal neurologic dysfunction. Doctors will effectively be placing patients into suspended animation in a sci-fi-esque attempt to save lives. This study is sponsored by the U.S. Department of Defense and will take place at UPMC Presbyterian Hospital led by Dr. Samuel Tisherman. Tisherman and colleagues have successfully demonstrated EPR-CAT in studies on pigs and dogs. The encouraging animal results prompted the clinical trial in humans; this study at UPMC is the first in the country.

This study unique in that it is conducted under an exception from the standard informed consent process, as patients involved will not be conscious to provide informed consent, which has raised ethical concerns. However, this procedure has the potential to save gunshot and stab wound victims from almost certain death; under traditional care, these patients have a less than 10% chance of survival.

Innovation is imperative to improving health outcomes in this country. It is trials like these that give me hope that the standard of care will continue to rise and that there is a bright future for healthcare in America.