Go Back   Flash Flash Revolution: Community Forums > General Discussion > Critical Thinking
Register FAQ Community Calendar Today's Posts Search

Reply
 
Thread Tools Display Modes
Old 05-1-2007, 10:29 PM   #1
slipstrike0159
FFR Player
 
slipstrike0159's Avatar
 
Join Date: Aug 2005
Location: In the shadows behind you with my assassin's blade waiting to strike
Posts: 569
Send a message via MSN to slipstrike0159
Default Previous medical procedure completely wrong?

Newsweek published an article that said:
Quote:
Originally Posted by Newsweek
May 7, 2007 issue - Consider someone who has just died of a heart attack. His organs are intact, he hasn't lost blood. All that's happened is his heart has stopped beating—the definition of "clinical death"—and his brain has shut down to conserve oxygen. But what has actually died?

As recently as 1993, when Dr. Sherwin Nuland wrote the best seller "How We Die," the conventional answer was that it was his cells that had died. The patient couldn't be revived because the tissues of his brain and heart had suffered irreversible damage from lack of oxygen. This process was understood to begin after just four or five minutes. If the patient doesn't receive cardiopulmonary resuscitation within that time, and if his heart can't be restarted soon thereafter, he is unlikely to recover. That dogma went unquestioned until researchers actually looked at oxygen-starved heart cells under a microscope. What they saw amazed them, according to Dr. Lance Becker, an authority on emergency medicine at the University of Pennsylvania. "After one hour," he says, "we couldn't see evidence the cells had died. We thought we'd done something wrong." In fact, cells cut off from their blood supply died only hours later.

But if the cells are still alive, why can't doctors revive someone who has been dead for an hour? Because once the cells have been without oxygen for more than five minutes, they die when their oxygen supply is resumed. It was that "astounding" discovery, Becker says, that led him to his post as the director of Penn's Center for Resuscitation Science, a newly created research institute operating on one of medicine's newest frontiers: treating the dead.

Biologists are still grappling with the implications of this new view of cell death—not passive extinguishment, like a candle flickering out when you cover it with a glass, but an active biochemical event triggered by "reperfusion," the resumption of oxygen supply. The research takes them deep into the machinery of the cell, to the tiny membrane-enclosed structures known as mitochondria where cellular fuel is oxidized to provide energy. Mitochondria control the process known as apoptosis, the programmed death of abnormal cells that is the body's primary defense against cancer. "It looks to us," says Becker, "as if the cellular surveillance mechanism cannot tell the difference between a cancer cell and a cell being reperfused with oxygen. Something throws the switch that makes the cell die."

With this realization came another: that standard emergency-room procedure has it exactly backward. When someone collapses on the street of cardiac arrest, if he's lucky he will receive immediate CPR, maintaining circulation until he can be revived in the hospital. But the rest will have gone 10 or 15 minutes or more without a heartbeat by the time they reach the emergency department. And then what happens? "We give them oxygen," Becker says. "We jolt the heart with the paddles, we pump in epinephrine to force it to beat, so it's taking up more oxygen." Blood-starved heart muscle is suddenly flooded with oxygen, precisely the situation that leads to cell death. Instead, Becker says, we should aim to reduce oxygen uptake, slow metabolism and adjust the blood chemistry for gradual and safe reperfusion.

Researchers are still working out how best to do this. A study at four hospitals, published last year by the University of California, showed a remarkable rate of success in treating sudden cardiac arrest with an approach that involved, among other things, a "cardioplegic" blood infusion to keep the heart in a state of suspended animation. Patients were put on a heart-lung bypass machine to maintain circulation to the brain until the heart could be safely restarted. The study involved just 34 patients, but 80 percent of them were discharged from the hospital alive. In one study of traditional methods, the figure was about 15 percent.

Becker also endorses hypothermia—lowering body temperature from 37 to 33 degrees Celsius—which appears to slow the chemical reactions touched off by reperfusion. He has developed an injectable slurry of salt and ice to cool the blood quickly that he hopes to make part of the standard emergency-response kit. "In an emergency department, you work like mad for half an hour on someone whose heart stopped, and finally someone says, 'I don't think we're going to get this guy back,' and then you just stop," Becker says. The body on the cart is dead, but its trillions of cells are all still alive. Becker wants to resolve that paradox in favor of life.
http://www.msnbc.msn.com/id/18368186...sweek?GT1=9951

Does this mean that more medical procedures actually killed more patients than it helped? If so, what does this mean about our general knowledge of medicine? Finally, if this is the start of many reevaluations of medical procedures then could we find a better way to treat something as horrible as AIDS or cancer?
__________________

slipstrike0159 is offline   Reply With Quote
Old 05-1-2007, 10:44 PM   #2
devonin
Very Grave Indeed
FFR Simfile AuthorFFR Veteran
 
devonin's Avatar
 
Join Date: Apr 2004
Location: Ontario, Canada
Age: 36
Posts: 10,098
Send a message via AIM to devonin Send a message via MSN to devonin
Default Re: Previous medical procedure completely wrong?

Okay...so what I'm getting from this is that they've astoundingly found a way to safely restart a heart that has been stopped for as much an an hour or more...But they didn't additionally assert that the brain suffering from a lack of oxygen for upwards of an hour or more would remain undamaged...

I'm not sure I'd -like- to be brought back from "death" even with a perfectly healthy and safe heart, if I had suffered any amount of brain damage as well.

As to your pondering as to whether "more medical procedures actually killed more patients than it helped?" I don't assert that this discovery proves that even of traditional heart attack treatments. The previous method may have saved fewer people than this proposed new method, but it -definately- saved more people than doing absolutely nothing would have.

A new discovery leading to a more effective treatment isn't a condemnation of previous methods, or of the ways in which those previous methods were applied. The field grows and changes, new discoveries lead to new treatments, lead to new cures. That's just the course of science and medicine.

I very much doubt that this is going to somehow call into question all of medical science, it was a new discovery that is leading to new treatments, the usefulness of which this article doesn't convince me of entirely on its own.
devonin is offline   Reply With Quote
Old 05-2-2007, 12:50 AM   #3
Kilroy_x
Little Chief Hare
FFR Veteran
 
Kilroy_x's Avatar
 
Join Date: Mar 2005
Location: Colorado
Age: 32
Posts: 783
Send a message via AIM to Kilroy_x
Default Re: Previous medical procedure completely wrong?

Well, sometimes drastic rewrites demonstrate dramatic flaws in previous medicine, but this is rare, and certainly not the case here. The amount of people not revived by previous methods was certainly greater than the number that this new method seems to be able to provide, but that doesn't mean the old method killed people.
Kilroy_x is offline   Reply With Quote
Old 05-2-2007, 05:17 AM   #4
GuidoHunter
is against custom titles
FFR Veteran
 
GuidoHunter's Avatar
 
Join Date: Oct 2003
Location: Texas
Age: 36
Posts: 7,379
Send a message via AIM to GuidoHunter Send a message via Skype™ to GuidoHunter
Default Re: Previous medical procedure completely wrong?

You can't seriously blame modern medicine for being ignorant of something so unintuitive. This is just another advance in the field of emergency treatment and resuscitation. Previous methods are by no means bad just because we found something that's better. Like they've said above me, 15% survival rate is MUCH better than a 0% survival rate.

Now, had we recently discovered something incredibly simple and easily tested was actually really harmful like, say, epinephrine actually poisoning you instead of helping you at all, then I think you could lay some blame on some people for not doing simple tests. However, this is something that very few people would consider, and fewer even would test.

This won't call for a reevaluation of modern medicine by any stretch of the imagination; it's just another advancement. It also won't miraculously lead to some discovery of an ingenious AIDS or cancer treatment. This is about people who died from cardiac arrest; there's really no correlation.

--Guido

http://andy.mikee385.com
__________________

Quote:
Originally Posted by Grandiagod View Post
Quote:
Originally Posted by Grandiagod View Post
She has an asshole, in other pics you can see a diaper taped to her dead twin's back.
Sentences I thought I never would have to type.
GuidoHunter is offline   Reply With Quote
Old 05-2-2007, 05:35 AM   #5
FalcoLombardi
FFR Player
FFR Veteran
 
FalcoLombardi's Avatar
 
Join Date: Oct 2006
Posts: 360
Default Re: Previous medical procedure completely wrong?

lets face facts, as time goes on, modern society will be far more developed to deal with such medical procedures. fact is, we are well ahead now of centuries past, it's just the tale of time that determines how advanced we can become
__________________


[SIGPIC][/SIGPIC]

"Perfection is not attainable, but if we chase perfection we can catch excellence..."
- Vince Lombardi
FalcoLombardi is offline   Reply With Quote
Old 05-2-2007, 10:51 AM   #6
Maid
FFR Player
FFR Veteran
 
Maid's Avatar
 
Join Date: Nov 2006
Location: 北海道 釧路
Posts: 643
Default Re: Previous medical procedure completely wrong?

Quote:
Originally Posted by FalcoLombardi View Post
lets face facts, as time goes on, modern society will be far more developed to deal with such medical procedures. fact is, we are well ahead now of centuries past, it's just the tale of time that determines how advanced we can become
Or nuke ourselves back to the stone age.
Maid is offline   Reply With Quote
Old 05-2-2007, 01:48 PM   #7
devonin
Very Grave Indeed
FFR Simfile AuthorFFR Veteran
 
devonin's Avatar
 
Join Date: Apr 2004
Location: Ontario, Canada
Age: 36
Posts: 10,098
Send a message via AIM to devonin Send a message via MSN to devonin
Default Re: Previous medical procedure completely wrong?

I think the really interesting thing about the advances of modern medicine is that medicine leads to our increased lifespan but our increased lifespan is why we need the advances in medicine. Our bodies are still being born with a 40 year lifespan intended. I mean, it should come as no surprise that things like our teeth start to go at a certain age, we start to go bald, go grey, and start to have our various internal organs lose efficiency. They're still built to only last 50 years, and all of this modern medicine is just an attempt to eke out a few more years of use from our body.
devonin is offline   Reply With Quote
Old 05-3-2007, 01:04 AM   #8
slipstrike0159
FFR Player
 
slipstrike0159's Avatar
 
Join Date: Aug 2005
Location: In the shadows behind you with my assassin's blade waiting to strike
Posts: 569
Send a message via MSN to slipstrike0159
Default Re: Previous medical procedure completely wrong?

Living longer just means you are dying slower...

At any rate, i was merely suggesting such questions to promote conversation, if i had thought it would be a one sided argument against me then i wouldnt have asked. Besides, a lot of the new medical breakthroughs help in the progression of helping against cancer and AIDS but they arent directly related.
__________________

slipstrike0159 is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump



All times are GMT -5. The time now is 10:29 PM.


Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2021, Jelsoft Enterprises Ltd.
Copyright FlashFlashRevolution