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Cardiac arrest from massive bleeding accounts for more years of life lost than heart disease and cancer combined, according to the Center for Disease Control and Prevention. But in a new controversial study by the University of Pittsburgh Medical Center that started in April, doctors are trying to buy more time by freezing people to save their lives.
The procedure, called EPR or Emergency Preservation and Resuscitation, was developed in 2000 with the help of Dr. Peter Rhee, known for saving the life of former congresswoman Gabrielle Giffords. In a normal trauma setting where a patient has suffered cardiac rest, surgeons would have roughly five minutes to correct blood loss; with only one in ten patients normally surviving. With EPR, surgeons would have an extra hour by draining all of the blood and flushing the system with cold saltwater to cool the body to 50F at which point the patient is clinically dead. The extra hour allows them to patch the wound and then slowly warm the body with donor blood and revive the person.
The research team is looking to test EPR on 10 people who have received a penetrating trauma from a gunshot or stab wound. The study is funded by the Department of Defense, but the most likely subjects will be from the largely African-American Pittsburgh neighborhoods that are plagued by gun violence.
The study raises ethical questions since the only way to opt out is to wear a bracelet that reads “No EPR Study.” Without the bracelet, a person is essentially consenting to the procedure.
To date, no patient has received the procedure. The team is looking to set up more test sites around the country.
Credit: Kimberly Brooks, CJ Dominguez, Bradley Blackburn, Jesse Swinger