oxygen is bad.....????

[Sandog]

Similar to cryogenically freezing, stops everything cold?

I don't think that idea worked out to well in the 80's either.

If... There was such a drug to halt cellular respiration, and halt all body functions, then important homeostatic functions would be shut off as well; for example, there would be a loss of temperature and pH regulation. Without body temp regulation, important body enzymes would unravel and fail. If pH were to deviate too much further cell damage would occur and organ failure would follow.

I just don't see this stasis drug happening anytime soon.

 

[Aidey]

^^^ Isn't that basically what they are trying to do with cold therapy in cardiac arrest situations. Not stop things, but slow them down significantly?

 

[Veneficus]

Okay, so, in an attempt to walk myself through this and understand...


We're talking about reperfusion injuries in that... When perfusion stops and cells switch to anaerobic respiration, lactic acid is produced, etc, and the resulting movement of blood circulation again basically spreads the icky bad stuff everywhere. Got all that down.

But the stasis-inducing drugs are meant to completely stop the respiration, aerobic or otherwise? Therefore, no lactic acid is produced, as the cell doesn't do anything. And you can correct the problem and reperfuse properly without having to worry about circulating the icky bad stuff... Correct?

Similar to cryogenically freezing, stops everything cold?

Lactic acid is not by itself terrible, the liver can convert it back to pyruvate (a few other cells can too) with some efficency, so circulating it to the liver is a good thing. But like every thing else in medicine, too much overloads the system.

(have to do the work thing now, more on this later)

 

[mycrofft]

Vene, thanks.

As always, the relative benefit needs to be weighed and the pt watched. As long as we give O2 or other tx as a knee jerk protocol reaction...see 4th paragraph.

1. Petrie dish versus in vivo. The liver can do stuff with lactic acid but wherever the acid is sitting or moving-by in any great concentration it is an irritant and is worthless until the liver has had a go at it. Where are the follow-ons demonstrating long-term effects of short-term O2? (Segue here....).

2. This is an example of why field EMS is not classically "a profession". Only rare rigorous studies are designed and controlled by EMT's, Paramedics, or medical controllers; thereby, no "independent body of knowledge".

Some of you younger techs out there, go get your PhD's or MD's and then come back to "EMS Ghetto" and give back to the community by setting up and doing these sorts of SCIENTIFIC studies.

To get back to the OP, oxygen is a drug, and a drug is a poison given in sub-lethal doses for it's beneficial side effects (per my pharm treacher, 1982). You are giving it under a medical protocol reviewed by a medical director, said protocol acting in lieu of a direct medical direction/order. You must evaluate for the need, then treat the need, not "just give 'em some O2".

 

[skippy54]

My post was directed at abeth86, which would put us in agreement.

It doesn't send the cell in to anaerobic respiration, it halts most metabolism all together. It's akin to putting you under an anesthetic. Your brain functions decline, but you're still there.

I heard the 1st author speak about this a few days ago (first I had heard of it....brilliant physician, very very cool work imho), and he was especially interested in moving this into the pre-hospital and military environments. They're envisioning an autoinjector setup, apparently.

Yeah, that's what I was talking about.

If... There was such a drug to halt cellular respiration, and halt all body functions, then important homeostatic functions would be shut off as well; for example, there would be a loss of temperature and pH regulation. Without body temp regulation, important body enzymes would unravel and fail. If pH were to deviate too much further cell damage would occur and organ failure would follow.

I'm not entirely sure what the "stasis treatment" (for lack of a better term) would do to things like body heat, but if the body isn't really doing anything on a cellular level then pH regulation isn't much of an issue - it will stay the way it was when the drug was administered. Body heat isn't as important to life as many may think in the short term, either. See the new cardiac protocols calling for induced hypothermia. It's all short term stuff, to keep you from dying of shock before life saving treatments can be given.

 

[mycrofft]

Here's the magic drug; H2S, the latest sucide craze

http://www.nature.com/nbt/journal/v27/n1/full/nbt0109-13.html

 

[skippy54]

Epinephrine can kill you in large doses, too, you know.

 

[JPINFV]

Epinephrine can kill you in large doses, too, you know.

So can ingesting water in sufficient enough quantities. "There's no such thing as too much of a good thing" is a lie.

 

[mycrofft]

abeth, if I get epi in my dental lidocaine I get cardiac.

I hear you loud and clear.

 

[skippy54]

If you don't think up and coming things are good, that's on you. I prefer to stay on the cutting edge and save as many lives as possible. New technology and techniques are a *good thing*.

 

[JPINFV]

If you don't think up and coming things are good, that's on you. I prefer to stay on the cutting edge and save as many lives as possible. New technology and techniques are a *good thing*.

To be fair, new tech can also be a bad thing. Thalidomide anyone? Fen-phen? Additionally, when the comment is 'some dude on some website talk about something that doesn't make a whole lot of sense given how you're describing it' (i.e. "locking the ability of cells to get oxygen") should breed skepticism.

 

[Mountain Res-Q]

To be fair, new tech can also be a bad thing. Thalidomide anyone? Fen-phen?

Speaking of which, I found a sample box of vioxx in my parents med drawer last week... expired in 2004... needless to say they got flushed... lol ^_^

 

[Sandog]

Body heat isn't as important to life as many may think in the short term, either.

From a biology perspective this statement is simply absurd. Human enzymes/proteins require a very optimal balance of temperature and pH or they will quickly denature.

I am sure there will come a time when such treatments are available, but not today. If you like, I can provide some reference reading in regards to protein denaturing.

 

[jrm818]

From a biology perspective this statement is simply absurd. Human enzymes/proteins require a very optimal balance of temperature and pH or they will quickly denature.

I am sure there will come a time when such treatments are available, but not today. If you like, I can provide some reference reading in regards to protein denaturing.

No squabbles with the proteins denaturing argument, but if abeth is really talking about the same putative treatment that I am, than it would appear that such treatments, while not available today, might be shortly. Of course, the treatment I was speaking about doesn't "put cells into stasis," which is a very tough thing to do, as you say. Instead, it activates cellular "survival pathways" with the general goal of preventing apoptitic death (and maybe necrotic?) after cellular insult from systemic things like massive trauma.

However, since her information seems to have come off of some random website, I wouldn't be surprised if "hibernation" or "stasis" was used in the article as an analogy to try to explain the process to a general audience that likely knows little or nothing about cellular signaling cascades or aptoptosis (not implying that abeth "got it wrong", just speculating that the author she read might not have maintained scientific accuracy). It wouldn't be a completely wrong analogy anyways, it seems to me, as even the activation of "pro-surivival" pathways results in cellular resistance to hypoxic derangement that would otherwise produce massive cellular death. Not stasis, but it's still a pretty stunning development, especially given what you and JPINFV have been saying about the inability to overcome a lack of oxygen (never mind the other physiological derangement that accompany massive hemorrhage). Wild and crazy stuff....

Or, possibly, abeth and I could be talking about different things, and I'll let you get back to your regularly scheduled programming.

 

[skippy54]

We're talking about the same treatment, jrm818.