In the past ten weeks, we’ve deployed six standby operations and have performed three stabilizations and cryopreservations (including A-2340 discussed in a previous entry).
Of the two most recent cases one patient required two standbys and the other three in advance of cardiac arrest. They were performed on opposite coasts, with the first patient coming from California and the second from Florida. Both patients were successfully stabilized, transported, cryoprotected and cooled.
Member A-1026 was admitted to the hospital in southern California a couple of weeks ago; and once there, he became infected with MRSA bacteria. He became septic and suffered renal failure, as the infection failed to respond to treatment. His condition worsened when the doctor ceased all treatment except that needed for the patient’s comfort, and he suffered cardiac arrest on 30 April at 06:30.
Our transport vehicle and personnel were nearby. Hospital personnel administered the first few stabilization medications and performed chest compressions until team members arrived. Alcor personnel had driven out with the transport vehicle the night before, so it was available for the case. Two members of the regional team assisted with the stabilization. They transported the patient to a local facility for washout after completing surface cooling, medication administration and cardiopulmonary support. Subsequent — and extensive — femoral surgery did not reveal femoral veins that were adequate to perfuse the patient. A straight flush was done using 18 liters of a saline and hydroxyethyl starch solution.
Due to delays in obtaining the doctor’s signature on the death certificate, transporting the patient to Arizona was nearly delayed an extra day. Because he was a neuro patient, we chose instead to perform a cephalic isolation in California. Doing this eliminated the immediate need for a transit permit, because the brain is considered a tissue sample and is not subject to the same regulations as human remains. It was a choice of last resort, and was only done because an additional 24 hours delay would prevent us from being able to cryoprotect the patient. The patient arrived at the lab at 00:25 on 1 May, almost exactly 18 hours after pronouncement.
We needed a half hour to prepare the patient, including making the burr holes and cannulating. The cryoprotection went exceptionally smoothly, and the only problem encountered was leaking that developed in two separate thermocouple ports in the circuit. These leaks did not impact the patient at all, but they were already an issue we knew had to be dealt with in future circuit designs. This experience simply gives us more reason to ensure we find alternatives sooner rather than later.
Cryoprotection concluded at 05:33 when we achieved (and sustained for 30 minutes) target concentrations, and the first stage cooling began shortly thereafter. Cooling concluded without incident, and he was transferred to long-term care on 15 May.
A-1026 is our 81st patient.
In March, Alcor performed a thirteen-day standby in Florida for a member (A-1831) who suffered a massive heart attack while sitting in a hospital lobby. His wife was having surgery, and he ended up requiring admission himself. Over the course of those nearly two weeks, that member went through three separate surgeries. Those surgeries left his heart in improved condition, but the member had become dependent on ventilator support.
While Alcor was initially deploying from Arizona, the staff of Suspended Animation stood by at the hospital. They provided us with their still-under-construction transport vehicle, so that we would have the means to take the patient to the local funeral home for blood washout. We chose to deploy our new stabilization kit, rather than the one we have stored in the SA facility, because we thought it an excellent opportunity to test the new design, especially knowing that we had a backup in the other kit in case we forgot something critical. We borrowed SA’s ice bath (for use in a moving vehicle) and gas cylinders to power our thumper, though we ultimately lacked compatible connectors to power our device. Though the stabilization kit was not needed, we were satisfied with the composition of the new kit (with that one exception) and believe it would have allowed quality care had our member required stabilization at that time.
Upon release from the cardiac care unit, A-1831 was transferred to a long-term care facility. He remained on a ventilator, and complicating health factors made medical personnel unwilling to attempt removing him from the vent. Periodic attempts were made to wean him at the new facility, but all were ultimately unsuccessful. A brief deployment was again necessary mid-April, but the member recovered slightly once again.
On May 10 at 19:00, we received a call from hospital personnel that the member had taken a turn for the worse, and that they were calling his family as well. We contacted SA and made our own arrangements to deploy additional personnel for the standby and stabilization, but the member suffered cardiac arrest a short 45 minutes later. SA personnel completed a stabilization protocol consisting of surface cooling, medications, and cardiopulmonary support. The patient was transported to Arizona the following day for cryoprotection.
He arrived in the facility at 20:15 the next day (nearly thirty hours after his pronouncement), which to date matches the longest transit time we have seen prior to successful vitrification. Though we were a little bit concerned about the potential for swelling of the brain (edema) during cryoprotection, we proceeded with the standard protocol. We did see some edema early in the cryoprotection, but it was limited and relatively minor compared to other cases we have seen in the past. The procedure as a whole went quite smoothly, with no problems at all.
Target concentrations were achieved, and cryoprotection concluded at 02:05 on 12 May. First-stage cooling started fifteen minutes later, and all cooling concluded without incident.
A-1831 is Alcor’s 82nd patient.