Departure of Aschwin de Wolf

After working for Suspended Animation for two-and-a-half years, Aschwin de Wolf has decided to relocate primarily in the Phoenix area and will be available to assist us only as an independent contractor in the future. Aschwin was the first employee to join the company after the change in management that occurred in 2004, and participated in a wide range of activities, from studying the biology of processes following cardiac arrest to establishing a new book keeping system. Suspended Animation has relied on his advice regarding patient stabilization and we hope to continue to draw upon his expertise in the future.

Earlier this year Melody Maxim decided to return to her former occupation collaborating with her husband in their own business. We are fortunate to have benefited from the substantial review that Melody performed of our air-transportable perfusion kit (ATP) while she was here. In the time since her departure we have made the principal changes which she suggested, and we will be adding some final detail modifications pending a review from a perfusionist in California.

We are pleased to announce that Todd Huffman has entered into a contract to provide consulting services for Suspended Animation on a regular basis. Todd visits our facility for one week each month and has already been extremely helpful to us, running training sessions, developing training materials, and working on a perfusion monitoring system for our operating room.

Todd recalls that his original ambition was to become an emergency room physician. “To me cryonics seems like a rational extension of modern medicine,” he explained to us recently. He first learned about cryonics when he read an article on Extropianism in Skeptic Magazine.

The son of a firefighter, Todd is no stranger to the demands of emergency work. In high school he took night classes at a local ambulance station, and CNA (Certified Nursing Assistant) classes at a local hospital. “At the time I wasn’t even old enough to take the certification tests,” he recalls. Subsequently he received EMT-B and CNA certification, and in college went through two years of a nursing degree as a precursor to going to medical school. He left this path when he decided that he wanted to move into research. Still, he worked as a CNA and emergency room technician on and off for five years.

After Charles Platt encouraged Todd to become an Alcor employee, Todd moved to Arizona and worked fulltime at Alcor during 2003. He has since played an active role in several cryonics standby/transport procedures.

Todd has a bachelors degree in neuroscience and a masters in computational biosciences. He is a Ph.D. student in cellular and molecular biology. Outside of cryonics, he is primarily interested in the electrophysiology and morphology of large neural network computation.

The past two years have been an unusual period in cryonics in that very few cases have occurred. Alcor went for more than a year without a case, and for more than two years Suspended Animation has not been called to assist any of its clients affiliated with the American Cryonics Society or the Cryonics Institute. Since our objective is the protection of human life, we are happy that fewer people need our help than statistics would have led us to expect. At the same time we are concerned that our team members should remain alert and ready to respond in an emergency.

During a visit from Todd Huffman we encouraged him to design two training sessions. In many ways these were worst-case scenarios since they provided no opportunity for prior preparation and required an immediate local response without any assistance from our affiliated paramedics.

In the first simulation team members were told that a patient was only hours from death in an apartment near the SA facility. This case was made more interesting when team members opened the freezer to obtain ice and found a note that Todd had left there telling them to imagine that all the ice had melted as a result of a power failure. Ice was purchased from local convenience stores, equipment was deployed on-site, but simulated pronouncement of the patient occurred before the ATP could be used. Medications were pushed while the patient was brought back to the facility for simulated blood washout. We were pleased with the resourcefulness and the level of energy in our team members, but concerned by some failures to follow protocol.

The second simulation involved a case where the patient supposedly had been pronounced just half-an-hour previously, again in an apartment not far from our facility. Rapid deployment was achieved, the dummy patient was moved from an upstairs room, and the ice bath was used in a patio area before it was loaded into the vehicle. Once again the procedures for blood washout were practiced at our facility.

While a simulation obviously cannot substitute for the real thing, team members did get an accurate idea of the tensions and decision-making that are characteristic of transport work. We were pleased that the ice bath, the Thumper, and the Sprinter vehicle performed to specification, but we were concerned that insufficient data were gathered during both cases. Lack of data acquisition has always been a problem in cryonics, and we now have a clearer perception of the factors which can lead to it being overlooked under the time pressure of an emergency. New data collection sheets will be developed, and team members will practice data logging.

Version 2 of our liquid ventilation equipment has been completed and bench-tested. We will be demonstrating it at our conference in May of this year, after which it will be subjected to additional laboratory testing in California.

For a basic explanation of the concept and purpose of liquid ventilation, please see our conference brochure at http://www.suspendedinc.com/conference/SA_conference.pdf
or our previous news bulletins, which are archived at http://www.suspendedinc.com/news_archives9.html. In the three months since our last report in January we have completed extensive modifications to make the system more portable, more effective, and easier to use.

Since liquid ventilation provides the fastest possible reduction in body temperature short of extracorporeal bypass, it is an extremely exciting concept. Making it field-deployable on a practical basis has been the big challenge. We believe we are now closer to achieving this.

The roller pump which was used to move chilled perfluorocarbon into and out of the lungs has been replaced with two other pumps, both running on 12 volts DC. Bench tests have shown that the new pumps provide higher flow rates and better suction while using less power. Preliminary work suggests that we can eliminate the pinch valves that were used previously, and the high cooling efficiency of our design has enabled us to use one heat exchanger instead of two. After we found that the supply tubing picked up too much heat from the environment, we developed a flexible icewater tubing jacket that delivers liquid to the patient at less than 1.5 degrees Celsius.

A search for the ideal thermostat to control perfluorocarbon temperature was fruitless, and led us to build our own simple circuit based around a thermistor. This can be fine-tuned to the most desirable degree of accuracy. Three nickel metal hydride (NiMH) battery packs weigh considerably less than the lead-acid equivalent, and can be recharged witho ut removing them. They should provide at least two hours of continual operation.

The control panel for the liquid ventilation system allows manual or automatic cycling, and can use 115 volts AC if available. The onboard AC-DC converter is medically rated.

The entire system, including tubing, tools, and accessories, fits into two model 1610 Pelican cases. They can be mounted on a wheeled frame which collapses for shipment. We expect to place photographs of this system on our web site in the near future.

In our previous news bulletin we discussed the deficiencies of currently available gas-driven systems for administering chest compressions after cardiac arrest. The need for compressed gas in massive steel cylinders has been a frequent problem in standby work.

When we first read about an electrically driven CPR device marketed as the AutoPulse, we were hopeful that we might be able to make use of it. The design uses a single battery pack to power an electric motor which reels in a thin belt around the chest of the patient. The entire system is contained in a contoured plastic backboard, to which the patient can be secured. The system is self-adjusting and capable of running for twenty minutes on one battery charge.

While the Michigan Instruments Thumper and the Swedish-designed LUCAS both use a “high impulse” gas-driven piston, the AutoPulse squeezes the chest by constricting it over a large area. Since this force is applied from multiple directions, the manufacturer claims it is actually more effective that the impact of a rubber pad or cup that hits the front of the chest only. Naturally Michigan Instruments disputes this claim, but there has been no head-to-head comparison test of Thumper and AutoPulse, and so far as we can tell, either system may produce good results if it is applied correctly. This may be more easily achieved in the case of the AutoPulse, which regulates the force and extent of its contractions automatically by processing signals from two pressure sensors positioned under the patient’s back.

The problem, from our point of view, is that we must induce rapid cooling while chest compressions continue. Even if we use liquid ventilation to cool the patient, we still plan to use an ice bath as well. The backboard of the AutoPulse is not designed for immersion in water, and cannot be waterproofed to protect the internal electronics.

Since the Suspended Animation ice bath is fitted with strong side rails, we wondered if there would be a way to invert the AutoPulse and mount it between the rails, extending its belt down around the patient on a system of pulleys. A quick sketch suggested that this should be feasible, so we took the risk of buying a $15,000 AutoPulse and disassembling it.

Initially we were dismayed by the quantity and sophistication of electronics that we found inside. The system uses four separate circuit boards closely wired together. We also found that if the processor does not receive the quality and type of signals from the pressure sensors that it considers acceptable, it stops itself and displays an error message.

Undaunted, we built a preliminary version in which the machinery and electronics of the AutoPulse were mounted above the patient while its pressure sensors were protected from water by placing them under the vinyl liner of the ice bath. A preliminary test of this configuration at a California laboratory yielded generally good results, but we remained unhappy with the need to position the pressure sensors relative to the patient. If the patient’s position changed, the system would stop working.

We have now built our second version of the design, using a frame and rubber membrane around the pressure sensor to waterproof it so that it can go inside the ice bath. The AutoPulse now stands on struts that are attached to the pressure sensor so that everything remains in alignment.

We we have now purchased a second AutoPulse for modification. Using this system to administer chest compressions, powered by relatively lightweight batteries, will be a major improvement in cryonics standby work. We hope and expect to demonstrate this at our conference in May of this year. Once again we remind you that the conference program is online at http://www.suspendedinc.com/conference/SA_conference.pdf

While pondering the redesign of the AutoPulse we realized that if a battery-driven system could exert sufficient force, muscle power should also be able to work a belt-based system. As spinoff from our AutoPulse project we developed an ultra-simple, ultra-cheap device for this purpose. This was mentioned briefly in our previous news bulletin. We can now provide additional details.

The design uses two handles pivoted on a base that rests on the chest. Semicircular reels draw in a belt when the user pushes down on the handles. Preliminary tests yielded cardiac output that appeared to be equal to the output from an electrically driven AutoPulse. The system does require some strength and stamina, but considerably less than ordinary manual CPR, and we have redu ced the length of the handles to achieve greater efficiency. While a longer handle provides better leverage, it also requires larger arm movements which themselves can be tiring. Thus, the optimum length for the levers is a tradeoff between force and motion.

An electrically powered system will always be superior, since it can run unattended for as long as freshly charged batteries are available. Still, a manually operated device could be cheap enough to be a standard emergency item in any home where someone may be at greater-than-average risk of cardiac arrest.

A patent search revealed the existence of a hand-powered device developed by a small startup named Deca-Medics. Their prototype is pictured at http://www.deca-medics.com/?cid=3.

However, we believe it will be far more difficult and expensive to fabricate than our simplified version, which people with basic workshop skills could easily make for themselves at a cost of perhaps $25. Our model will be displayed and demonstrated at the conference in May.

The development of our Sprinter rescue vehicle has continued incrementally. Folding jump seats have been installed, and a new floor covering has been poured using an epoxy-based compound to seal the entire area. We poured an identical floor in our second vehicle—a windowless airport shuttle bus built specially for us by a company in Alabama.

Very few additional improvements remain to be made in the Sprinter, which is currently our number-one response vehicle and remains loaded with a full set of standby equipment at all times.

In the near future we will be finalizing plans for the shuttle bus depending on the tasks that it will be expected to perform. Liquid ventilation and an ATP will be built into the vehicle, but must also be usable outside of the vehicle if circumstances require this. Resolving these conflicting demands will be a challenging design exercise.

A long-term goal at Suspended Animation has always been to perform whole-body perfusion with vitrification solution in our operating room. For local cases this will enable the best possible treatment to mitigate post-ischemic injury.

To minimize the toxicity of vitrification solution, perfusion must be followed immediately by rapid cooling. Transport to a storage facility must then be accomplished in a very stable environment which holds the temperature around –135 degrees Celsius.

Last year some of us visited the Cryonics Institute where Ben Best and Andy Zawacki were kind enough to demonstrate the rapid-cooling enclosures and control software that they use. This year we built a prototype insulated container which is now being tested to assess its performance with a dummy patient.

Immersion of a patient in liquid nitrogen would be a very quick and effective way to achieve rapid cooling, but is unacceptable since the temperature at any point inside the patient must not be allowed to fall very far below the glass transition point (around –135 to –140 degrees Celsius). Consequently our system uses liquid nitrogen vapor—the same principle adopted by Alcor and CI.

Two large fans have been installed in a duct above a heavy-gauge aluminum tray that will support the patient. Liquid nitrogen flows into the enclosure in steel pipes which absorb heat from the environment as the liquid vaporizes and emerges through small jets. The fans blow the mixture of cooled air and nitrogen gas onto the patient powerfully enough to disrupt the boundary layer of warm air that exists close to the skin. The air/gas combination then recirculates via the overhead duct. The aluminum tray draws heat from under the body and radiates it into the air stream.

Initially we ran the fans for several days to assess their reliability. The fan shafts had been extended into the enclosure through additional bearings, and we wanted to be sure that the bearings (which are rated for cryogenic use) would not deteriorate over time. We have created a dummy patient using a highly viscous fluid mixture which we believe will conduct heat similarly to a human body. At the time of writing, we are getting ready to perform our first cooling tests.

Currently the system is manually operated, but in the future we may seek to purchase rights to gratitude for their openness and willingness to help us in this and other projects. We believe that cryonics generally will benefit from such a welcome spirit of collaboration without unnecessary secrecy. We also thank Brian Wowk for taking some of his valuable time to advise us regarding this project.

As reported in our January bulletin, we began work on a new portable ice bath to fit specifications provided for us by the Cryonics Institute. CI wanted a paramedic-style bath with legs that would automatically collapse when the bath was pushed into an emergency vehicle.

This work has been completed. The bath will remain here so that we can show it with our other equipment during the conference. After that, it will be moved to Michigan.

SA has now built three ice-bath variants. Our most portable model is packed ready for air transport. Two noncollapsible models are used in conjunction with ramps and a levelling device, compatible with our transport vehicles. The CI model is in some ways more versatile, since it will fit (for example) into the rear of a Chevy Suburban. However, we are expecting to use the space under our noncollapsible ice baths for permanent stowage of equipment such as a liquid ventilation system. Therefore we will continue to favor that ice-bath design for the immediate future.

As the references indicate above, we will be demonstrating some exciting new equipment at the conference on Saturday, May 19th and during the tours of our facility on Sunday, May 20th. Demos will include liquid ventilation, electrically powered CPS, the manually operated chest-band CPS system, collapsible ice bath stowage and deployment, rapid cooling enclosure, and ice bath access to vehicles via our custom-fabricated ramps.

Some features of the operating room are not yet complete, but it will be open for inspection along with all other areas of the facility, and attendees will be able to talk to all our employees and many of our consultants during and after the lunch-time buffet.

The conference itself will feature entirely new presentations, perhaps most notably the keynote speech by Dr. Gregory Fahy describing a three-year initiative to improve wholebody cryopreservation in animals.

Until April 30th conference registration fee per person is $125, which includes the Friday welcome reception, Saturday banquet, and Sunday lunch-time buffet. From May 1st onward the registration fee increases to $175. To register please call us at 1-800-984-0914.