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The Cryonics Institutes 165th Patient

by System Administrator / Friday, 23 March 2018 /

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Cryonics Institute Case Report for Patient Number 165

 

CI patient #165 was a 59 year old female from Maryland.  The patient was a CI member at the time of her death.

 

The patient died at home, under hospice care, and was pronounced at 1:45 am on March 14, 2018. After pronouncement took place, her son and husband transferred her into a body bag and began the cool down with ice. They were well prepared with the basic standby kit and Zeigler case that they purchased from CI. An EMT assisted them in carrying her to the Ziegler case, which also serves as a portable ice bath, where they administered Heparin and Maalox, performed chest compressions, and covered her entire body with ice. The funeral home chosen by the family came prepared with extra ice to compensate for ice used up during the initial cool down. They then transferred her to the funeral home and worked quickly to obtain the paperwork needed for her transportation. 

 

The patient arrived at the CI facility at 10:30 pm, approximately 21 hours after death.  The patient was in the Ziegler case with a generous amount of ice and the Ziegler case was well insulated with both polystyrene insulation and fiberglass wool insulation. The nasal temperature upon her arrival was -1.2c, though there were no signs of surface freezing.  

 

Hillary Martenson performed the perfusion.  The perfusion was completed at 12:20 am.  During the perfusion there were 3 liters of 10% Eg solution and 6 liters of 30% Eg solution used, and 25 liters of 70% VM1 solutions used.  The final refractive index of the effluents exiting the right jugular vein was 1.4216.  The final refractive index of the effluents exiting the left jugular vein was 1.4216. The average perfusion pressure was held at 115mm and metal cannulas were used. Flow rate started at 1.69 liters per minute and was reduced to 1.46 liters per minute by the end of the perfusion. The nasal temperature was -9c at the end of the perfusion. 

 

There were no blood clots noted during the perfusion and there was good flow from both of the jugular veins. The entire body was perfused and dehydration along with bronzing of the skin was visible through the trunk, as well as in the arms and legs. Significant dehydration of the head and face was noted along with a bronzing of the skin. No edema was noted in the patient’s body or head, nor was any edema noted in the brain when observed through the burr hole in the patient’s skull. The perfusion of both the head and body was very successful. It was evident that the knowledge and effort put into the standby and stabilization done by the son and husband played a big role in the success of the perfusion. 

 

The patient was then transferred to the computer controlled cooling chamber to cool to liquid nitrogen temperature.  The human vitrification program was selected and the time needed to cool the patient to liquid nitrogen temperature was five days and 11 hours.  The patient was then placed in a cryostat for long-term cryonic storage. 

The following is the detailed standby report received from the patient’s son, Matthew Deutsch: 

 

In 2006 my mother, Linda Deutsch, was treated for breast cancer. Ten years later, the cancer remerged and metastasized into the spine. At first it was responsive to radiation, however, in January of this year it became cerebrospinal-fluid-mobile and metastasized into her brain ventricles and liver. She was given months to live. Seven years earlier, I was signing my dogs up with the Cryonics Institute. Upon my advice my mother purchased a yearly CI membership. We never thought it would actually be used, and for years I had paid no mind to the notarized years-lapsed contract that they had on file. Because my father is a secular man and wishes the best for his wife and family, and because my sister has my mother’s grandchild on the way which she would not live to see, he agreed to fund her cryopreservation out-ofpocket with stipulations on standby, stabilization, and transportation expense. In the final weeks, I scrambled to put her standby protocol, supplies, and funeral home transportation in place. My good buddy Nicholas Reef Van Der Mullen and his wife, Nicole Rodriguez, made arrangements to fly here the night of the 15th of March, a few days before my mother’s projected expiration, however, she took futile chemotherapy pills out of tenacity which ended up robbing her of those few days. I had been exercising a loose personal standby leading up to Nick and Nicole’s arrival with the assistance of two under-mattress SIDS alarms, which detect breathing through minute vibrations. Early in the day on the 13th, hospice had delivered a special adjustable hospital bed with an electric pneumatic mattress that uses a continuous pump to adjust firmness. Immediately, I identified the problem of false positives on the SIDS alarms. I arranged a next-day replacement with a regular mattress. Fortunately, I bought a third clip-on SIDS alarm as an additional precaution and this is the only one she had for the night. That night, at 1:20am, I was in the room with my mother who was sitting upright and drinking Pedialyte to recover from severe bile reflux. Her oximetry was erratic and blood pressure low, so hydration and initiation of supportive oxygen seemed prudent. After seeming to stabilize, she suddenly fell sideways onto the bed and coughed up a large mouthful of bile with her eyes rolling back. I called the nurse and four minutes later, I hear a beep coming from her waistband. It was the 15 second respiratory failure alarm. Within 15 seconds of the alarm going off, I confirmed cardiac arrest, got her on the floor, and began chest compressions. My father ran me the kit so I could switch to the ResQ Assist for compressions. I tried to ventilate with the bag valve mask, but the mask piece wasn’t in reach, so I had my father give a single breath from his mouth, removed the tongue depressor, looked at the oximeter to see it at 94%, and decided compressions were more important. All ventilation after this point was incidental of just chest compressions. Twenty minutes into compressions, we had our pronouncement. I moved my mother into the body bag and placed ten pounds of ice over and around the head and neck. I performed a few more compressions to reset ischemia, then a paramedic assisted my father and I in carrying her downstairs, into the garage, and into the Zeigler case. While my father continued compressions, I quickly moved the remaining 80 pounds of ice into the body bag in the Zeigler. It was originally going to stock another forty pound later that day per the original plan. I took over compressions to closely control initial cooldown and ice position over key vascular points such as face, neck, armpits, and groin. After a good few degrees below normothermic according to the nasopharynx thermocouple, I had my father take over compressions while I attempted to place the cardiac needle. I Hit the sternum three times. I shelved it and went for the interosseous drill, which I had ordered from CI individually by request in addition to sodium citrate as a backup nonthrombolytic anticoagulant. I had only studied

placement of the drill just a few hours prior; two fingers proximal to the tibial protuberance. I placed my fingers so, positioned the drill at the targeted concavity, and gave it my best smooth firm perpendicular push and twist. It was in, it was level with the skin. I unscrewed the initial puncture needle from the center and what was left was a perfect port exactly like in the YouTube EMT training videos or eXisenZ. Because the reservoir being accessed is much smaller than a heart atrium, I took the precautions of not priming through and using a J-Loop and not injecting without circulation. Fortunately I was able to skip the filter since there are many protective lymphs between the injection site and the brain, unlike the heart. One by one, I set up the syringes and purged the air pockets, then got back to compressions. My father smoothly depressed the plungers as I compressed, and this repeated until she received, in order, 40,000u of sodium heparin, 20mL of sodium citrate solution, and a saline flush. I removed the IO port, leaving a perfect clean target-shaped indentation. After more circulation, I inserted a  gastrointestinal tube through the nose and it slid down to the stomach with no resistance. I pushed 12mL of Maalox and removed the tube. I continued compressions until I got tired, then took breaks which I used to take temperature readings and prepare shipping ice for when the initial cooldown depletes what was purchased, going back immediately on new wind. I inflated the shampoo basin and placed it on the legs. With all of the ice packs from garage and kitchen freezers, there was enough to fully pack the head, torso, and abdomen without risk of shifting. Fortunately, the funeral home who I had just gone to for help earlier in the day and was supposed to meet with that morning prepared for the worse and had the needed tens of pounds of extra shipping ice on-hand and I was able to remove the ice packs and shampoo basin. I continued compressions and saved the last of my strength to perform a few minutes immediately before pickup to reset ischemia at 17C°. I emailed my mother’s brain imaging data to CI three to four hours prior in case a perfusion issue comes up related to cancer-induced vascular changes. The following morning, I receive an update saying that perfusion was not only successful, but outstanding in quality. My mother’s connectome was safe, she survived information theoretic death against all odds, and my job was done. My arms hurt a lot but it was all worth the effort and planning.

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