Hacking Surgery: Suspended Animation May Be Here

Suspended animation is a staple of science fiction. Need to take a 200 year trip to another star system? Go to sleep in some sort of high-tech coccoon and wake up at your destination. We saw it in Star Trek, 2001, and many other places. Doctors at the University of Maryland have reprtedly put at least one patient in suspended animation, and it isn’t to send them to outer space. The paper (behind a paywall, of course) is available if you have the medical background to wade through it. There’s also a patent that describes the procedure.

Trauma surgeons are frustrated because they often see patients who have been in an accident or have been shot or stabbed that they could save if they only had the time. A patient arriving at an ER with over half their blood lost and their heart stopped have a less than 5% chance of leaving the ER without a toe tag. By placing the patient in suspended animation, doctors can gain up to two hours to work on injuries that previously had to be repaired in mere minutes.

Normally once your heart stops, your brain will irreversibly damage in about 5 minutes due to lack of oxygen. The heart meanwhile can survive for about 20 minutes.  Doctors are replacing all of a patient’s blood with ice cold saline. This causes brain activity to stop and slows or stops chemical reactions that normally cause damage. Technically, the patient is dead.

Surgeons then have about two hours to do their thing before warming up the patient and restarting his or her heart. The FDA approved the study which plans to put up to ten people in suspended animation. The patients won’t have to consent because they have fatal injuries with no alternative treatment. However, the team did place ads in local newspapers with a web site that allows people to opt out if they don’t want the procedure in the future.

The thawing out remains problematic. As the temperature rises, chemical reactions can cause cellular damage. It appears that the longer you are dead, the worse this damage can be. Doctors hope to find a drug cocktail to help prevent these reperfusion injuries. The goal temperature is 10C and upon rewarming, they bring the patient up to 34C, about 3 degrees low and wait for the body to recover over a 12 hour period in most cases.

Working on pigs, they have been able to keep them cold for 3 hours and revive them. The report isn’t clear on exactly how many of the patients have been frozen and successfully thawed out, nor does it share how well the thawed out patients recovered. Presumably, that will be in the paper they publish next year.

We don’t suggest trying this at home, but it does lead to some interesting questions about your brain and conciousness in general. A few hours won’t get Kahn to Ceti Alpha V, but it could be a start of developing technology that could enable long space flight.

24 thoughts on “Hacking Surgery: Suspended Animation May Be Here

    1. There is also a quiet recent and nice to read Article about “Engineering Human Stasis for Long-Duration Spaceflight” in the Jurnal Physiology! They look at two approaches. First is hypothermia and the second is mimicing the natural processes of hibernating mammals. ( Nordeen, C. A., & Martin, S. L. (2019). Engineering Human Stasis for Long-Duration Spaceflight. Physiology, 34(2), 101–111. doi:10.1152/physiol.00046.2018 )

      btw: Medical articles behind a paywall can often be found as free pdf by google scholar (like the quoted article above) or otherwise over “open-science-sites” like sci-hub.

    1. Which is better: a 95% chance of death following normal protocols or uncertain but smaller chance of death with experimental procedure?

      Read your history, for example books by Jurgen Thorwald on history of surgery and medicine. Or read up on Unit 731 and how their work was taken and used by USA in exchange for immunity. And the entire world benefited from that immoral research. USA also did illegal medical experiments on their own citizens. And it was later than 1940s.

      When first heart transplants were attempted, chance of survival for the patients were slim at best. Experimenters always chose patients that would die anyway, usually in couple of weeks or months, and after the surgery (which is not that hard or complicated) they experimented with first immunosuppressants, radiation, etc. Some people died in hours, som survived for months. Someone had to do it, someone had to be the first, second, tenth. These early attempts ultimately failed but we learned form them…

      Someone always must be the first…

      1. In a medical setting, this might be the best choice even if it’s untested, to save people who will otherwise be dead in minutes.

        I’m not sure what medical ethics says about spaceflight, and I’m sure a lot of doctors will be uncomfortable with a dangerous procedure, to send people on an even more dangerous journey.

  1. This is already done, somewhat. My son was born with hydrocephalus and had to be transported across the state, so after stabilization he was chilled to prevent brain damage. I’m not sure the entire duration but at least a few hours including the flight.

    1. Yeah, this sorta concept is already done now.
      This is it just taken to even further extremes via the replacement of blood.
      Technically there has been that done as well on random trials non-officially, but this is it just being standardized and done proper.
      It could be pushed much further but this is just the start. Dealing with more exotic chemicals can come at a later point.

      One major issue with cooling the body too far down is it isn’t just the fact crystals could form in cells and burst them, it’s the _structure_ that becomes problematic. The brain particularly depends on a specific and very finely constructed structure, you pull and prod at that structure too much and there is no coming back – brain dead.
      So we’d need to figure out a way to actually freeze the brain SOLID before it gets below certain temperatures where shrinkage becomes a serious problem.
      Replacing CSF is a much more complicated procedure and could cause much worse outcomes with contamination risk.

      Then, of course, there is the issue of persistence.
      As far as we know, the human brain requires persistence to survive.
      Switch that off, doesn’t matter how healthy it is when it comes back on, the “OS is lost”. Hope you got a re-image disk handy.
      That’s a very very basic description of it, but the much longer one involves synaptic connections being broken, systems that keep the brain in synchronisation being shut down, etc.
      It happens in severe brain trauma and coma cases and those people never recover even when their brain is overwhelmingly healthy. (brain dead)
      It’s kinda like the cardiac arrest problems with polarization failure, the heart is a sequence, not a single pulse.
      Kickstarting that sequence properly is extremely hard. Doing it improperly can lead to a wonky ticker that will eventually stop again. You can’t just stick some paddles on there, those are only used to fix wonky heart rhythms, not start them.
      It’s very hard to come back from that. Actual full-on heart-stop scenarios have a very low mortality. Even in hospitals. TV lies to you. 20-30% IN hospitals and it drops to around 5% outside. And even when they do survive, typically they end up with severe disability and a poor overall life outcome anyway.
      Anyway, the point being is the brain may potentially be the same – a sequence of activity (rhythms) that when interrupted lead to total collapse of brain function.
      Hopefully that is not the case. That’d be a real dick-punch in cryogenics and stasis concepts.
      If it could save more people from sudden trauma and cardiac arrest, it would be an absolute game changer.
      The brain is the last boss, so we’ll be at it for a while.
      Oh well, there’s always biological hibernation via gene therapy.

      1. The last question on persistence sounds like something that would be suitable for those on death row. If they survive, no loss. If they do not, it sounds like it may arguably be a more humane death than some of the currently used methods. And they help science. Whether or not surviving would be a pass out of death row or just a ‘test’ before the scheduled execution is carried out is another matter.

    2. Your son was made moderately hypothermic but very much alive. His core temperature would have been around 35C or a bit lower, but he was breathing, heart pumping etc. This article refers to making people effectively dead – no pulse, respiration or brain activity and a core temp under 10C. Hope your son is Ok.

  2. So there is a crew in coma for 200 years or more. They reach destination and find out people are already there because 50 years after the voyage started a technology was invented to do space travels through X (where X is your choice – time space tunnel, quantum realm shortcut etc.). Now instead of starting colony on a new clean planet they end up on second earth with technology they will never follow, social problems that are new to history and maybe this planet needs to be evacuated already because new technology pollutes even faster and people have been here already more than 100 years and that is plenty time for a world war or two plus few minor riots or civil wars. And that is a lucky scenario – what if they already left and the crew reach only big sphere of dust and fire? This is serious!

    1. On the plus side the frozen crew could be “sleeping” for 10,000 years and the FTL colony could have been established, lived, crashed and now the survivors are living as pre-technological tribes, when the “sleepers” arrive they’re gods, not a bad outcome for a little nap.

      1. They could make the tribe build insanely big geometric figures of stones, than when they die noone would uderstand why they were build and how to make new.

        Seriously. This has a potential for a scifi tv show with every episode describing fate of different crew on different planet.

  3. A friend is volunteering their ex as a test subject. Says it should be easier with the ex as they’re fairly certain that the ex already has a cold heart, and likely a cold brain. They were put forward by the ex for the same reasons…
    I think we could tell both of them that the backup is they’ll scan their brain, then if required later, they can get it back with a 3D print, like the OLED TVs.

  4. Leave this for the sci-fi writers.
    Human physiology it not that simple or easy to achieve.
    I have as an anesthesiologists worked with planned hypothermia and circulatory arrest to do cerebral aneurysm clipping in selected patients. Failure to restart the heart was just one issue for a patient.
    But it is not just the patient/astronaut that is the problem. Resident in the bowel are billions of bacteria…how do we control them? They will still function albeit at a slower rate. But they need fuel……
    Then there is the aspect of monitoring and intervening if problems arise for the “stasis” astronaut. A resident on call medic would be needed.
    And cells don’t just switch off and then back on like a circuit, they slowly metabolize regardless. Another problem to solve if time were to be in the months, decades or centuries.

    They article is pure conjecture and non-scientific trash. No one has yet been able to document revival of those who opted for cryogenic storage and there is a host of intricacies there regarding ice crystal formation and cell destruction still to be resolved.

    Better to find a Stargate.

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