Vegetative State May be Caused by Brain Cooling from Oxygen Temperatures

Life News ^ | 8/4/06 | David Reardon

[wagglebee]

LifeNews.com Note: David Reardon is the director of the Illinois-based Elliot Institute.

The odds of recovery from brain injuries and vegetative states may be dramatically improved simply by restoring normal brain temperatures, according to a new medical theory published in the August issue of Medical Science Monitor.

The study was inspired by the case of 53-year-old woman who suffered a heart attack and oxygen deprivation of the brain. In the course of a few days she slipped from consciousness to coma and then to a vegetative state. For the following thirty-one months she was receiving oxygen through a tube in her trachea.

But one day it was noticed that the oxygen in the tube was over thirty degrees below body temperature, due to an equipment setup that appears to be common in many hospitals and nursing homes. Acting on the speculation that such chilled air could not be good for the patient, the tube was removed. One month later, the woman came out of the vegetative state and was verbal and able to respond to questions.

Inspired by this case, the authors began to investigate the physiological link between lung temperatures and brain temperatures. They found that chilled tracheal air will produce chilled aortic blood which will in turn produce a significant drop in brain tissue temperatures.

Because the path from the aorta to the brain is short, a drop in brain temperatures may occur even though the core body temperature otherwise appears to be normal. But even a small drop in the brain temperatures can produce important deviations in neurochemistry and the endocrine system. These changes, the authors suggest, may not only inhibit recovery they may even produce additional problems, including symptoms commonly associated with the poorly understood condition called a "persistent vegetative state."

To access the potential impact of their findings, the authors surveyed a sample of hospitals and nursing homes in the larger New York metropolitan area. Most health care facilities reported they do not heat the oxygen given to non-responsive, intubated patients.

The authors suggest that paying closer attention to intubated air temperatures, or removing intubation tubes as soon as practical, would pose no risk to patients and may well produce a significant increase in the rate of recovery from brain trauma. They also propose numerous strategies for future research.

Just last month, two other teams of researchers reported findings that have given new hope to the families of minimally conscious patients. One study found that the insomnia drug zolpidem may help patients recover from a vegetative state. The other reviewed brain scans of Terry Wallis, who emerged from a minimally conscious state 19 years after a brain trauma, and found evidence that the human brain may be more capable of repairing itself than previously thought.

The full text of the article is available free on line at Medical Science Monitor's website, http://www.medscimonit.com

Citing: Ford GP, Reardon DC. Prolonged unintended brain cooling may inhibit recovery from brain injuries: Case study and literature review. Med Sci Monit, 2006 12(8): CS74-79.

[wagglebee]

The study was inspired by the case of 53-year-old woman who suffered a heart attack and oxygen deprivation of the brain. In the course of a few days she slipped from consciousness to coma and then to a vegetative state. For the following thirty-one months she was receiving oxygen through a tube in her trachea.

But one day it was noticed that the oxygen in the tube was over thirty degrees below body temperature, due to an equipment setup that appears to be common in many hospitals and nursing homes. Acting on the speculation that such chilled air could not be good for the patient, the tube was removed. One month later, the woman came out of the vegetative state and was verbal and able to respond to questions.

And this was possible because she had a family doctors who wanted her to live.

[wagglebee]

Ping!

[wagglebee]

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[Fairview]

I can't believe it took us so long to figure this out. How could we have been so stupid for so long? How much loss has been caused because we didn't realize this?

[NonValueAdded]

The odds of recovery from brain injuries and vegetative states may be dramatically improved simply by restoring normal brain temperatures, according to a new medical theory published in the August issue of Medical Science Monitor.

You all know what that means.

[do the dhue]

The odds of recovery from brain injuries and vegetative states may be dramatically improved simply by restoring normal brain temperatures, according to a new medical theory published in the August issue of Medical Science Monitor

Alright then, I'll start gathering the liberals and you go get the ice.

[do the dhue]

liberals have a chance to recover?

[wagglebee]

LMAO!

[coconutt2000]

You all know what that means.

Exposing liberals to low level microwave energies might restore their sanity?

[do the dhue]

Exposing liberals to low level microwave energies might restore their sanity?

That's what I am thinkin' but lets face it, liberals are hopelessly hopeless.

[Arthur McGowan]

What it means is that heated air/oxygen will shortly be reclassified as "artificial life support."

[verum ago]

or if those fail, higher levels whenever they misbehave

[AmericaUnited]

Well, well, well, well, well!!! Some of us who were against 'terminating' people in these states, stated on reason was that medical discoveries might make them whole. And here we are.

[coconutt2000]

rofl

[Popocatapetl]

Boyle's Law strikes again!

V1*P1/T1 = V2*P2/T2

[sig226]

I think that things like this do not help our cause. The story is worthwhile on its simple merits. Here is a person who came out of a coma after 31 months.

To formulate a theory based on one, uninvestigated case is wildly irresponsible. Any scientifically minded euthanasia supporter will observe that people breathe 60 degree air all the time. People climb Mount Everest using oxygen. Their brains do not shut down at 29,000 feet, -20 degrees Fahrenheit.

These guys are reaching with this one. They would do much better to argue that the woman recovered because her last name is not Schiavo.

[ndt]

"I can't believe it took us so long to figure this out."

You might want to reign in the mia culpas, it's a hypothesis, nothing proved or even tested yet.

[Lady Jag]

Why, then, don't they heat the oxygen?

I wonder what this means for longterm use of under-heated CPAPs.

[TheSarce]

Ping...

[Redbob]

"How could we have been so stupid for so long?"

The first guy to make a wheel probably said the same thing...

[BookaT]

I understand your opinion. But I think this is worthy of more than a second look before saying it isn't true.

You point out some good but totally unrealated cases. Un-injured climbers, (have you spent time in a hospital? They are normally kind of cold) who are awake and moving or drinking warming beverages at regular interavals.

My thought is if you are in a room at 73ish degrees and are eating liquid to survive, that passes through a tube that is exposed to that 73 degree temp, and then are given O2 that is also going into your chest and maybe a little cooler than the room. and this goes on for weeks with nothing but a temp check daily or so of your core body temp.

I am just saying, I agree to pin your hopes on this one persons case, but don't compare anyone in the hospital to those freaks of nature that do stuff like climb mountains.

I would like to believe that people will study this more and maybe we will see something positive from it. For the patients not the climbers, well they can learn from it too I guess.

Thats all.

[aruanan]

Any scientifically minded euthanasia supporter will observe that people breathe 60 degree air all the time. People climb Mount Everest using oxygen. Their brains do not shut down at 29,000 feet, -20 degrees Fahrenheit.

All these people are breathing through their noses and mouths. They're not getting chilled air pumped directly into their lungs.

From the paper:

Subsequent review of the patient’s record revealed that no entry was made for the patient’s temperature on the fi rst and second day after the cardiac arrest, while she was on a ventilator. The fi rst temperature (rectal) recorded in the charts, on the morning of the third day, was 26°C (78.8°F). The next measurement, approximately two hours later, 35°C (95°F) followed by a brief dip to 31°C (87.8°F). Thereafter, for the remaining 22 days on the ventilator, the records show the rectal temperature remained in the range of 33–35°C (91.4–95.0°F). While in the long-term care facility, records show the patient’s rectal temperature was typically record- ed between 97° and 100°F (36–38°C).

The record review also revealed that the blood tests performed just before transfer to long-term care revealed traces of opiates though the patient’s last known exposure to opiates would have been at the time of the overdose that triggered the car- diac arrest. It would seem that this could only be possible if the function of the patient’s hepatic metabolic system was suppressed, which is a symptom of hypothermia [6].

[politicalwit]

Garbage article....supplemental humidification and heat adjustment has been standard operational protocol for the admninistration of compressed gases on patients with trachs for the past thirty-five years or more. Sounds more like a poor long term care facility and improper airway management more than anything else. In all probability the reversal of her neurological state would have occurred with out without the tube removal.

[sig226]

If you breathe air that is below zero fahrenheit, the temperature gradient is more than enough to make up for the difference regarding the trach tube. I really think this idea has absolutely no merit at all, but it could be studied as they suggested with MRI scans and cooled air designed to simulate the effect in a healthy person. It could be studied even more accurately by convincing tracheotomy patients to volunteer for the study.

To propose a theory based on the outcome of one case is guesswork at best. It is an equally valid theory that the transfer from this facility to that facility, coupled with a given number of changes of bed linens, cures coma.

Of course, it doesn't, but in this case the correlation is there.

[ReignOfError]

To formulate a theory based on one, uninvestigated case is wildly irresponsible.

That's not what was done here. The doctors noted one case, then researched the existing literature and found that underheated air could inhibit recovery, and that the existing recommendation to use a heated nebulizer was often not followed.

At most, this is a direction for future research, though there's no indication that immediately heating the air for long-term patients -- a, again, is already recommended -- would add any risks.

[ReignOfError]

I wonder what this means for longterm use of under-heated CPAPs.

Not much, I'd wager. Air from a CPAP is warmed by passing through the nasal passages and sinuses, just like the air you breathe when you're awake. That's an entirely different matter from air forced directly into the trachea and lungs.

[sig226]

Then the people who wrote it shouldn't call it a hypothesis.

[ReignOfError]

Then the people who wrote it shouldn't call it a hypothesis.

Why not? That's what it is.

hy·poth·e·sis Pronunciation Key (h-pth-ss)
n. pl. hy·poth·e·ses (-sz)
1. A tentative explanation for an observation, phenomenon, or scientific problem that can be tested by further investigation.

[trisham]

Most health care facilities reported they do not heat the oxygen given to non-responsive, intubated patients.

*************

I'm rather surprised at this. It doesn't speak well of those caregivers.

[8mmMauser]

Pinged from Terri AUGUST Dailies

8mm

[Mrs. Don-o]

I use a CPAP, and I wondered about that, too. It has a heated water reservoir to humidify the air, but in the summertime I've often often left it off because in warm weather the heated CPAP made my face sweaty.

As of now, I'm crankin' up my air conditioner to a cooler temperature at night, so I can tolerate the CPAP on a warmer setting. (Does that make sense?)

[Lady Jag]

I'm glad you asked because ReignOfError gave me the answer yesterday and I forgot to thank her/him.

Quote:   Air from a CPAP is warmed by passing through the nasal passages and sinuses, just like the air you breathe when you're awake. That's an entirely different matter from air forced directly into the trachea and lungs.

I agree 100% with that answer, so there's nothing to worry about.

[Mrs. Don-o]

Thank you! (Breathing easy now!)

[aruanan]

If you breathe air that is below zero fahrenheit, the temperature gradient is more than enough to make up for the difference regarding the trach tube.

The patient's body was hypothermic for about 22 days. Also, usually if one is breathing air that is below zero, one is fairly active physically. The increased physical activity is sufficient to prevent hypothermia. This evidently was not the case with a patient in a coma.