One of our members, A-1212, suffered cardiac arrest in Hawaii last week. The gentleman had suffered a fall and been released from the hospital, and then he fell a second time. On this admission to the hospital, he was diagnosed with pneumonia. Treatment with antibiotics was going well, but his heart stopped suddenly. We were not notified until between 15 and 30 minutes after pronouncement. Negotiations with the hospital for the application of our emergency protocol did not go quickly or smoothly. Ultimately, they did agree to begin surface cooling and administered an intranasal dose of heparin (They had removed all IV lines before we were called and were unwilling to place a new one.) before releasing him to the funeral home.
Initial negotiations with funeral homes in Hawaii were also difficult, as none were willing to commit to rapid transit. We went through three separate facilities to find one that would carry out our instructions. With all the delays, it was a full 42 hours after pronouncement that the patient arrived at Alcor, which proved faster than the original 3-4 day estimates.
The decision was made to attempt cryoprotection. We know from previous cases that vitrification is achievable after 30 hours and application of the medication protocol and surface cooling, and we decided to see if it was possible to improve our understanding of the limits to vitrification. It was quickly established that 42 hours with little surface cooling and virtually no meds, vitrification was not possible. We then straight-froze the brain.
During this case, there was much discussion of whether or not to remove the brain, chemically fix it and do a diffusion cryoprotection. Because insufficient data exists to tell us whether this would have resulted in superior structural preservation, we chose to use our standard protocol.
This patient received our 5th cryopreservation of the year, and he is our 83rd patient.
