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Authors: Sanjay Gupta

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17
. Andrea Zeiner et al, “Mild resuscitative hypothermia to improve neurological outcome after cardiac arrest: a clinical
feasibility trial,”
Stroke
31, no. 1 (January 2000): 86–94.

18
. “Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest,”
The New England Journal of Medicine
346, no. 8 (February 2002): 549–56.

19
. “2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care,”
Circulation
112, no. 24 (December 2005): IV-136–IV-138.

20
. U.S. Food and Drug Administration, Center for Devices and Radiological Health, Circulatory System Devices Panel, minutes
of meeting on September 21, 2004.

21
. U.S. FDA, CDRH, minutes from meeting on September 21, 2004.

22
. Carmelo Graffagnino, MD, Duke University, in interview with the author’s team.

23
. Edna Kaplan, Medivance spokeswoman, in interview with author’s team.

24
. Marcus Ong and others, “Controlled therapeutic hypothermia post-cardiac arrest compared to standard intensive care unit
therapy,” presentation to the 2006 Society for Academic Emergency Medicine.

25
. Raina M. Merchant and others, “Therapeutic hypothermia utilization among physicians after resuscitation from cardiac arrest,”
Critical Care Medicine
34, no. 7 (July 2006): 1935–1940.

26
. Raina Merchant in interview with the author and his team.

27
.
http://www.med.upenn.edu/resuscitation/hypothermia/protocols.shtml

28
. Zeyad Barazanji’s medical records.

29
. Mary Grace Savage in interview with the author. Her husband, Patrick Savage, is a deputy chief with the FDNY; a detailed
timeline of his rescue was laid out in the
New York Daily News
on July 3, 2007.

30
. John Freese in interview with the author’s team.

31
. I came to know the work of Audrey de Grey while researching my previous book,
Chasing Life
. Among other things, I had dinner at the home of his research assistant, Michael Rae, who is practicing another radical longevity
strategy: a diet of severe calorie restriction.

32
. Jennifer Chapman in interview with author’s team.

33
. CBS’s
The Early Show
, February 3, 2000.

CHAPTER TWO: A HEART-STOPPING MOMENT

  
1
. Unless otherwise noted, information on the Mike Mertz case comes from interviews conducted by the author’s team with Mike
Mertz, Corey Ash, and Chuck Montgomery, Glendale Fire Chief.

  
2
. Bentley J. Bobrow, “Minimally interrupted cardiac resuscitation by emergency medical services for out-of-hospital cardiac
arrest,”
Journal of the American Medical Association
299, no. 10 (March 2008): 1158–1165.

  
3
. Benjamin S. Abella, “Reducing barriers for implementation of bystander-initiated cardiopulmonary resuscitation,” AHA Scientific
Statement,
Circulation,
published online January 14, 2008.

  
4
. U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality,
http://www.innovations.ahrq.gov/content.aspx?id=1737
.

  
5
. Gordon Ewy in interview with the author’s team.

  
6
. Myron L. Weisfeldt and Lance B. Becker, “Resuscitation after cardiac arrest: a 3-phase time-sensitive model,”
Journal of the American Medical Association
288, no. 23 (December 2002): 3035–3038.

  
7
. Ewy, interview.

  
8
. American Heart Association, “About sudden death and cardiac arrest,”
http://www.americanheart.org/presenter.jhtml?identifier=604
.

  
9
. Leonard Cobb et al, “Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital
ventricular fibrillation,”
Journal of the American Medical Association
281, no. 13 (April 1999); 1182–1188.

10
. Gordon A. Ewy, “Cardiocerebral resuscitation: the new cardiopulmonary resuscitation,”
Circulation
111, no. 16 (April 2005): 2134–2142.

11
. Gordon A. Ewy, “Continuous-chest-compression cardiopulmonary resuscitation for cardiac arrest,”
Circulation
116, no. 25 (December 2007): 2894–2896.

12
. Ewy, interview.

13
. Mike Kellum in interview with the author’s team.

14
. Mercy Health System website,
http://www.mercyhealthsystem.org/body.cfm?id=7

15
. Kellum, interview.

16
. M. Kellum, K. Kennedy, and G. Ewy, “Cardiocerebral resuscitation improves survival of patients with out-of-hospital cardiac
arrest,”
The American Journal of Medicine
119, no. 4 (2006): 335–340.

17
. Mike Kellum and others, “Cardiocerebral resuscitation improves neurologically intact survival of patients with out-of-hospital
cardiac arrest,”
Annals of Emergency Medicine
52, no. 3 (September 2008): 244–252.

18
. Bentley Bobrow in interview with the author’s team.

19
. We spent time with several paramedics in Glendale during the writing of this book; all recalled intense initial skepticism
about Bobrow’s approach. Perhaps the most interesting story came from paramedic Crystal Sorenson. A day before he visited
her firehouse, she had performed a highly unusual resuscitation on a dog belonging to her son’s girlfriend. The dog had apparently
collapsed with no heartbeat, due to an allergic reaction to a bee sting. While Sorenson dug through the house for a shot of
epinephrine, her son, on her instructions, pressed on the dog’s chest, but—as you might imagine—gave no rescue breaths. Despite
more than ten minutes with his heart stopped, after receiving the shot of epinephrine, the dog revived with no obvious long-lasting
ill effects. With that experience fresh in her mind when Bobrow gave his presentation, Sorenson was more receptive than most
to the new protocol.

20
. Bobrow, “Minimally interrupted cardiac resuscitation.”

21
. Taku Iwami, “Effectiveness of bystander-initiated cardiac-only resuscitation for patients with out-of-hospital cardiac
arrest,”
Circulation
116, no. 25 (December 2007): 2900–2907.

22
. I found another simple but successful intervention in an unlikely spot. Perhaps no public place on earth is so closely
watched as the gaming floor of a Las Vegas casino. Security cameras hang in every conceivable location. In the mid-1990s,
Dr. Terence Valenzuela of the University of Arizona realized that the cameras—and the people watching them—could do more than
scan for drunks, card cheats and criminals. Valenzuela and colleagues convinced thirty-two casinos to install automated defibrillators
in all public areas, trained the security guards to use them, and taught them basic CPR. Over the next two and a half years,
105 casino patrons suffered what doctors would consider a “survivable” cardiac arrest. More than half the victims lived to
walk out of the hospital, at least ten times better than the typical survival rate. To this day, the safest place to have
your heart give out is probably the floor of a Las Vegas casino. (As detailed in
The New England Journal of Medicine
343, no. 17 (2000): 1206–1209.)

23
. R. Dunne and others, “Outcomes from out-of-hospital cardiac arrest in Detroit,”
Resuscitation
72, no. 1 (2007): 59–65.

24
. Graham Nichol and others, “Regional variation in out-of-hospital cardiac arrest incidence and outcome,”
Journal of the American Medical Association
300, no. 12 (September 2008): 1423–1431.

25
. Graham Nichol, director of emergency care at the University of Washington Harborview Center for prehospital care in Seattle,
in interview with the author’s team.

CHAPTER THREE: SUSPEND DISBELIEF

  
1
. This estimate is based on the following: the LC-50 (concentration that would kill half the people exposed to it) for hydrogen
sulfide is 800 parts per million. That can be converted to 0.8 grams per liter. Fanciful as it may be, one could thus say
that 0.8 grams of H
2
S could kill approximately half the people exposed to it; therefore an ounce of H
2
S could kill approximately 18 people. This experiment will not be conducted any time soon.

  
2
. This is based on standard material data safety sheets; these are two examples:
www.mathesongas.com/pdfs/msds/MAT11210.pdf
and
http://avogadro.chem.iastate.edu/MSDS/hydrogen_sulfide.pdf

  
3
. Mark Roth in interview with the author.

  
4
. Roth was named a 2007 Fellow by the John D. and Catherine T. MacArthur Foundation.

  
5
. Brett Giroir, former DARPA director, and Jon Mogford, director of DARPA’s Surviving Blood Loss Program, in interviews with
the author’s team.

  
6
. In 2007, Ikaria merged with a more established biotech company, New Jersey–based INO Therapeutics, which had existing facilities
for the production of gas-based medical therapies. Several news reports put the value of the merged company, Ikaria Holdings,
at $670 million. The company has approximately 300 employees.

  
7
. Many news outlets, including CNN, covered Uchikoshi’s hospital news conference on December 20, 2006. That remains the only
time he has spoken of the incident in public.

  
8
. The precise triggers of apoptosis remain a subject of intense research, but the role of cytochrome c has been detailed
by several scientists. The primary source for this description is an interview I conducted with Dr. Lance Becker of the Center
for Resuscitation Science.

  
9
. Roth, interview.

10
. Roth, interview.

11
. Roth, interview; Pamela A. Padilla and Mark B. Roth, “Oxygen deprivation causes suspended animation in the zebrafish embryo,”
Proceedings of the National Academy of Sciences
98, no. 13 (March 2001): 7331–7335.

12
. Roth, interview. The television documentary was “The Mysterious Life of Caves,” on
Nova.

13
. Some scientists believe that our cells naturally produce minute quantities of hydrogen sulfide, and that our ability to
use the molecule may be an artifact of prehistoric evolution, when certain microbes used it as a nutrient, in the absence
of oxygen. See Katharine Sanderson, “Emissions Control,”
Nature
459 (May 2009): 500–502.

14
. Roth, interview.

15
. Eric Blackstone, Mike Morrison, and Mark B. Roth, “H
2
S induces a suspended animation–like state in mice,”
Science
308, no.5721 (April 2005): 518.

16
. Atul Gawande, “Casualties of war: Military care for the wounded from Iraq and Afghanistan,”
New England Journal of Medicine
351, no. 24 (2004): 2471–2475.

17
. Giroir, interview.

18
. Michael Morrison and others, “Surviving blood loss using hydrogen sulfide,”
Journal of Trauma-Injury Infection & Critical Care
65, no. 1 (2008): 183–188.

19
. Neel R. Sodha and others, “The effects of therapeutic sulfide on myocardial apoptosis in response to ischemia-reperfusion
injury,”
European Journal of Cardiothoracic Surgery
33 (May 2008): 906–913; Florian Simon and others, “Hemodynamic and metabolic effects of hydrogen sulfide during porcine ischemia/reperfusion
injury,”
Shock
30, no. 4 (2008): 359–364.

20
. Ralf Rosskamp, MD, Ikaria Vice President of Research and Development, in interview with author’s team.

21
. National Institutes of Health website. The updated status for Ikaria trials can be found by visiting
www.clinicaltrials.gov
and searching for Ikaria.
http://www.clinicaltrials.gov/ct2/results?term=ikaria

22
. David Lefer in interview with the author.

23
. “Severe heart attack damage limited by hydrogen sulfide, study shows,”
ScienceDaily
. Retrieved April 17, 2009, from
www.sciencedaily.com/releases/2007/09/070919093319.htm
.

24
. Lefer, interview.

25
. Matt Andrews in interview with the author’s team.

26
. Kathrin Dausmann and others, “Physiology: Hibernation in a tropical primate,”
Nature
429 (June 24, 2004): 825–826.

27
. Jeff Williams, CEO of VitalMedix, in interview with author’s team.

28
. Andrews, interview.

29
. A signature paper of Chaudry’s appeared in the
Archives of General Surgery
, vol. 138 in 2003 (pages 727–734). An overview of his work can be seen by running a PubMed search:
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Search&db=pubmed&term=Chaudry%20IH

30
. Irshad Chaudry in interview with the author.

31
. A CNN crew interviewed Dr. Alam and filmed one of his swine surgeries for a story that aired November 10, 2006.

32
. National Center for Injury Prevention and Control, WISQARS Leading Cause of Death Reports, 1999–2005:
http://webappa.cdc.gov/sasweb/ncipc/leadcaus10.html
.

33
. Philip Bickler in interview with the author.

34
. Roth, interview.

35
. I explored the science of survival at high altitude in the 2004 CNN documentary
Life Beyond Limits
.

CHAPTER FOUR: BEYOND DEATH

  
1
. The description of Duane Dupre’s heart attack, near-death experience, and subsequent resuscitation is based on his own
account, given in an interview with the author’s team.

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