Finding better ways to save lives

Lance Becker from Penn's Center for Resuscitation ScienceLance Becker hopes to develop new methods—more advanced methods, at least, than simple ice cubes—to help cool a person down after cardiac arrest. Doing so can triple their chances of survival.
Photo credit: Candace diCarlo

The introduction of cardiopulmonary resuscitation, or CPR, by Dr. Peter Safer in the late 1950s was a landmark moment in medicine. The method revolutionized emergency medicine and has saved an untold number of lives.

Unfortunately, says Lance Becker, the medical community hasn’t done much of anything in the past half-century to improve on Safer’s system.

“We took a big step up with modern CPR,” says Becker, a Penn professor of emergency medicine. “But that was 50 years ago. And we’ve really not taken any huge steps since then.”

Becker is working to change that through the new Center for Resuscitation Science, a new research center dedicated to improving care for, and survival rates of, victims of sudden death. The Center has set an ambitious goal: To improve critical care to the point where a full 50 percent of people who have been “dead”—no heartbeat, no respiration—for 15 minutes can actually be brought back to life.

“Right now, we know that once you get beyond five minutes [of arrest], 50 percent of those people are going to die,” says Becker, who serves as the Center’s director. “No matter what you do with CPR or anything else, you’re not going to change that. We want to get to 15 minutes and 50 percent, which would mean at 5 minutes we would get a high percentage back. If we did this we would save hundreds of thousands of lives.”

Penn’s isn’t the only university with a center focusing on this emerging field. But Becker says few, if any, of the nation’s other centers can match the scope of work being done here.

The Center has gathered leading thinkers from medicine, the sciences and even engineering in a broad-based effort to change the way the medical community, and even the public, perceives critical-care medicine. The Center will conduct research on the cellular level and also work to develop new tools that could help medics and doctors better treat victims of cardiac arrest. Becker has already done that in his career, playing a key role in the development of the automatic external defibrillator, a device that can be used by untrained people to restart the heart.

“The vision is to take our ideas … and move them all the way out to the field, so we can actually save people’s lives,” Becker says.

In the moments after a person goes into arrest, Becker says, there are a few specific things that can be done to increase their chances for survival. CPR is one. The use of a defibrillator, which can re-start the heart, is another. It’s also important that patients start receiving advanced medical care, from trained medics or physicians, as soon as possible.

But Becker says a patient’s chances for survival can double or even triple of through the process of “cooling.” Dropping the body’s temperatures by just a few degrees, he says, can go a long way to saving a life.

The problem, he says, is that there are no devices available that can cool a body easily and quickly. This is just one of many areas he believes the Center can intervene, both by increasing awareness of the importance of cooling and by developing innovative technologies that can be deployed, in an emergency, just like a defibrillator. “That’s why it’s so important that we have engineers here,” Becker says.

Becker believes the Center really can achieve his stated “15-minute” goal. In fact, he says it may happen sooner than some might think.

“What we’ve got is a trail of evidence that it’s possible,” Becker says. “It’s a 5 to 10 year horizon to get some good work done.”

Originally published on September 6, 2007