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Humanity's ultimate challenge! Why can a body temperature as low as 9°C save lives?
In modern medicine, deep hypothermic circulatory arrest (DHCA) is a compelling surgical technique that allows doctors to temporarily stop the patient's blood circulation and lower body temperature during complex operations. Extend the time it can be safely paused. Once the body temperature drops to between 20°C and 25°C, or even as low as 9°C, it may become the key to saving lives. What scientific principles are hidden behind this?
The purpose of deep hypothermic circulatory arrest is to allow doctors to have a better view without blood flow when performing operations such as brain surgery.
History and Application of DHCA
The history of deep hypothermic circulatory arrest can be traced back to the 1960s, when surgeons discovered that lowering the body's body temperature could prolong survival after circulatory arrest. This technology already plays a key role in repairing large arteries, intracranial aneurysms and other major surgeries. Among them, Canadian surgeon Wilfred Bigelow's discoveries in the 1940s paved the way for this technology. Through experiments on cooling animals, he verified that when cooled to 30°C, , animals' brains can survive longer periods of cessation of blood circulation.
In 1963, Christian Barnard and Velva Schreier first used DHCA to repair an aortic aneurysm, and the patient's body temperature dropped to 10°C.
Physiological mechanism and safety
When the body temperature decreases, the metabolic rate of the cells decreases, which allows the cells to retain energy to cope with the lack of oxygen after the blood circulation stops. Scientists have found that when the brain temperature reaches 18°C, brain electrical activity almost completely stops, a so-called "computer quiescent state," allowing doctors to perform surgeries more safely. This technology does not just rely on lowering body temperature, but protects the brain from potential damage through multiple physiological mechanisms.
"Cooling provides critical protection, allowing the brain to reduce the production of oxidative free radicals and immune-inflammatory processes when circulation ceases."
The evolution of cooling technology
With the development of science and technology, cooling technology has gradually improved. In the past, doctors used snow or ice to treat wounds, but today's hospitals use a variety of advanced cooling systems, such as intracorporeal vascular cooling systems. These technologies not only accurately regulate body temperature but also effectively prevent excessive reheating to protect patients.
Potential complications and risks
Although DHCA provides important physiological protection, the rewarming process must be done with caution when performing this technique. If a patient's body temperature rises too quickly, it may lead to adverse neurological outcomes, including seizures or impaired consciousness. Research shows that every 1°C increase in reheating significantly increases a patient's risk of neurological damage.
"Faced with continued risks and challenges, whether the medical community can explore the secret of survival at a lower body temperature remains a major issue in the future."
Future challenges and research directions
Currently, the medical community is moving toward research on clinical levitation, such as the combination of hypothermic circulatory arrest and trauma treatment. Researchers hope to be able to rapidly lower body temperature in severely injured patients when they experience cardiac arrest, providing longer emergency treatment, which may change our definition of "death." Many experts pointed out that the application of this technology at the emergency scene will bring about a more revolutionary change in emergency medicine in the future.
To sum up, the advancement of DHCA technology not only has wide applications in surgical medicine, but also opens up new thinking about the limits of human survival. As research deepens, will the possibility of a human body as low as 9°C become the norm in the future of medicine?
