Prolonged, Unintended Brain Cooling May Inhibit Recovery from Brain Injuries

More Hospitals & Governments Push for Organ Transplants 5 Minutes or Less After Heart Stops

MO Planned Parenthood Does Not Have to Repay Mispaid Family Planning Funds

Educator Urges Teachers to Consider Alternative to NEA

PROLONGED UNINTENDED BRAIN COOLING MAY INHIBIT RECOVERY FROM BRAIN INJURIES: Case study and literature review. Background: Tracheal intubations of comatose patients are common, but contrary to most standards for respiratory care, heated nebulizers are not always used. This deviation from recommendations appears to be widespread.

 Case Report: In the case examined, a tracheotomized patient suffering from severe anoxic brain injury was unintentionally exposed to chilled air, 17°C (63°F) at the cannula, for a period of 31 months. A month after upper respiratory tract warming was restored the vegetative state lifted, as marked by the patient’s ability to verbalize responses to questions.

Conclusions: This clinical experience led us to a review of the literature. Among other findings, we learned that brain temperature is strongly affected by the temperature of arterial blood flow. Arterial blood, in turn, is strongly affected by the air temperature in the lungs.

Experiments have shown that the introduction of colder air in the lungs will produce rapid cooling of at least some surface brain tissues. Chilled aortic blood is also more viscous and less efficient in transfer of oxygen. Hypothermia of brain tissue may significantly affect the endocrine system and neurochemistry. Through inferences from the literature, we also identify other possible effects. We hypothesize that intubated delivery of air into the lungs at a temperature significantly below body temperature, especially over a prolonged period, is likely to inhibit recovery and may even produce iatrogenic effects. We recommend the use of heated nebulizers. Research strategies are recommended. key words: brain temperature • respiratory care • tracheal intubations • vegetative state • pituitary dysfunctions • encephalomalacia • growth hormone • coma • selective brain cooling  [Med Sci Monit, 2006; 12(8): CS74-79, PMID: 16865070 Related Articles in PubMed, Accepted: 2006-05-19 George P. Ford, David C. Reardon] 

MORE HOSPITALS/GOVERNMENTS PUSH FOR ORGAN TRANSPLANTS 5 MINUTES OR LESS AFTER HEART STOPS. A growing push has arisen from the medical community to increase the number of available human transplant organs by removing organs from non-brain-dead organ donors who experience “cardiac death” (CD) or 5 minutes of cardiac arrest. A recent article in the New Scientist, entitled “Not brain-dead, but ripe for transplant,” once again brings the contentious procedure back into the limelight.

The procedure, known as "donation after cardiac death" (DCD) or non-heart beating organ donation (NHBD) gained notoriety earlier this year in Canada after an Ottawa hospital announced in June its first DCD transplant. Currently the Australian Health Ethics Committee (AHEC) is considering recommending that the government encourage DCD, and government support in the United Kingdom has swelled numbers of DCDs by six-fold in the last 15 years to 120 in 2005 [New Scientist].

Yet the procedure is fraught with pitfalls, with many expressing fear that more doctors may be willing to sacrifice patients in order to harvest their organs to supply the worldwide demand. The New Scientist article relates the story of a 20-year-old “Janet,” who, following a car accident, suffered such extensive injuries that she would have been deemed eligible to have her organs harvested according to DCD’s standards. Janet, however, subsequently recovered and is “wheelchair-bound but happy to be alive.” In many countries, transplant surgeries only take place after doctors determine that a donor-patient is “brain-dead”...and therefore has no chance of recovery. Heart and lung function are maintained by way of life support in order to preserve the donor’s organs until surgeons find a suitable moment to harvest them.

The typical DCD donor patient, however, would have his life-support or ventilators removed in order to bring about cardiac death. The doctors would remove ventilation from a patient who typically has measurable brainwaves but is deemed unlikely to recover, and then wait for the heart to stop beating.  If the heart stops for 5 minutes, death is pronounced and the organs are harvested by another surgical team. "These situations put the physician in the difficult decision-making position between the care of their patient and balancing that care against the possibility of passing on the patient's organs to someone else," said Mary Ellen Douglas [Campaign Life Coalition’s National Organizer]. "The code of the physician is to do no harm and a heart-wrenching decision between two patients places the physician in the role of playing God." Christopher Doig [critical care specialist, Canada's Foothills Hospital, Calgary, Alberta] according to the New Scientist, described the use of CD to increase the number of organ donations as “inherently bothersome.”

According to the New Scientist, a presentation at the World Transplant Congress in Boston, MA, claimed that the widespread practice of DCD could increase the number of available transplant organs by 20 per cent and treat many of the estimated 6000 people in the US who die each year while waiting for a matching organ donation. However, pro-life advocates and many doctors are strongly against changing the determination of death to put more harvested organs in the medical market, especially since there have been a number of cases where patients have recovered after the proposed 5 minutes for determining “cardiac death”. The New Scientist also reveals that 3 US transplant centers use a 2-minute interval, since they claim at this time there is complete loss of brain function, and the heart could only rarely start beating again. Dr. Moira McQueen  [Pres, Canadian Catholic Bioethics Centre] told LifeSiteNews.com that waiting only 5 minutes after cessation of cardiovascular circulation was "frankly . . . not nearly enough” and noted cases of auto-resuscitation after more than 5 minutes without a heart beat, a condition doctors describe as the "Lazarus phenomenon.”

"The laudable purpose of saving lives does not justify the donation of an organ whose removal could cause the death of a donor," said Jim Hughes [Click’s National President]. "Harvesting organs just five minutes after the heart stops is just plain frightening. There are cases of people whose hearts have re-started after a longer period of time.” Related: Controversial Organ Donation Method Begins in Canada - Organs Extracted 5 Minutes after Heart Stops http://www.lifesite.net/ldn/2006/jun/06062707.html [8Aug06, Smith, LifeSiteNews.com]

MO PLANNED PARENTHOOD DOESN'T HAVE TO REPAY FAMILY PLANNING FUNDS to the state, about $900,000 it wasn't supposed to receive. That's the decision of the Missouri Supreme Court, which overturned a judge's ruling who said the abortion business owed the money. County Circuit Judge Moentmann ruled in June of last year that a prohibition on state family planning dollars going to affiliates of abortion businesses was constitutional. He said the state Health Department wrongly awarded the money to PP despite language in the state budget preventing family planning dollars from going to abortion facilities. But the state's high court reversed him Tuesday on a 4-3 ruling. The high court said there was no legal ground to justify making Planned Parenthood pay back the taxpayer money. [LifeNews.com 10 Aug06]

MAJOR VICTORIES! Several pro-family bills were signed into law during this Congress, including the Broadcast Decency Enforcement Act, the Fetal Farming Prohibition Act, the Freedom to Display the American Flag Act, the Stem Cell Therapeutic and Research Act, and the Children's Safety and Violent Crime Reduction Act.

EDUCATION LEADER URGES TEACHERS TO CONSIDER ALTERNATIVES TO NEA. A non-union conservative teacher's group says it is holding the National Education Association (NEA) accountable for its liberal agenda by offering state and local alternatives to that most powerful of America's teachers unions. In response to the NEA's endorsement of homosexual "marriage" at its recent convention in Orlando, FL, teachers have been fleeing the union for other groups, such as the Christian Educators Association International, and the Association of American Educators (AAE).

Tracey Bailey, the 1993 National Teacher of the Year and Director of Education Policy for the AAE, says tens of thousands of teachers have called his group to express their outrage over the NEA's political agenda. At its Orlando meeting, liberal NEA approved a resolution to amend a section of its anti-discrimination policy handbook to include homosexual "marriage," where it states the union's belief that discrimination based on "race, gender, sexual orientation, gender identification ... must be eliminated." The delegates' adoption of this resolution is "just another step in their direction of promoting controversial social agendas like gay marriage and abortion," Bailey asserts, "and they've been doing it for decades now."

Bailey says because AAE does not use members' dues for political activism, the alternative group is able to provide teachers with legal protection and benefits at a fraction of the cost of NEA dues. As for those members who feel they have no viable option to membership in the powerful national union, the award-winning teacher says those educators need to ask themselves what political issues and activism their dues are being used to support and how they feel about that personally and professionally. "In many places," Bailey notes, "we're looking for young conservative teachers, for retirees who can help us set up alternatives so that teachers will have a choice."

His group's desire, he explains, is to provide "a local choice" for teachers who object to the political direction the NEA has taken for years and its increasingly radical liberal agenda. With a presence in those teachers' communities, "there will be a conservative voice there to go to the school board and say not all teachers feel this way about these gay marriage issues or about some curriculum issues that the NEA has tried to push in the past." It is not too late, Bailey contends, for disgruntled teachers to leave the NEA over its endorsement of issues like abortion and homosexual marriage. In fact, he encourages teachers who object to NEA’s political agenda to drop their membership. [Jim Brown, 4Aug06 AgapePress]