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December 1, 2004

BehindTheMedspeak: 5 minutes without oxygen causes brain death - or does it?

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Alas, if you're human, it does: this sad fact is demonstrated every day when someone intubates the esophagus instead of the trachea and doesn't realize it until cardiac arrest occurs.

Sure, we've got all manner of oximeters and carbon-dioxide detectors, but what if the intubation's in a place like a hospital ward or out on the street at an accident scene, where there aren't such sophisticated monitors available?

Most vertebrates can only tolerate a similar short period of anoxia before cardiac arrest and brain damage ensue.

The graphic that heads this post demonstrates this cruel fact of life only too clearly: it shows that survival after cardiac arrest drops precipitously with each minute that elapses until CPR begins.

But it turns out that the crucian carp (Carassius carassius), a relative of the goldfish, can live with almost no oxygen for five DAYS with a perfectly beating heart.

Scientists reported in the October 1 issue of Science magazine that the fish transforms lactic acid, a damaging metabolic waste product, into much less harmful ethanol - the very same alcohol found in beer.

The researchers believe that the carp's heart helps circulate the ethanol through its gills and out into the surrounding water.

Such an adaptation allows it to survive the Scandinavian winter.

The scientists believe that an understanding of how this alternate metabolic pathway works could help save people who otherwise die as a result of hypoxia during heart attacks or strokes.

Most interesting.

I wonder if the goldfish in my lilly pond, which ices over in December and doesn't thaw until February, use this same mechanism to sustain themselves.

I mean, I can see them under the ice, moving around, yet they can't be getting any oxygen down there, and there sure aren't bugs or flying insects for them to munch on like in summer.

December 1, 2004 at 09:01 AM | Permalink


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Comments

My husband suffered an epsiode of not breathing, having seizures, following having surgery. All this happened in his room twenty minutes after being brought to room. It lasted 4-6 minutes. He had turned purple/red/blue. gurgling, seizing. The dr. claims no damage but I notice a LOT of changes inhis moods, memory, etc. where can I go for help and info.

Posted by: louise | Aug 15, 2005 12:27:06 PM

I just intubated someone on the hospital ward today, and using a clip on CO2 monitor, confirmed that I was in the trachea. They are cheap and turn from purple to yellow, so even an idiot like me can tell.

Posted by: Aaron | Dec 2, 2004 6:59:55 PM

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