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Case Report: Edward W CryoTransport Case Report: Edward W. Kuhrt, Patient A-1110 by Linda Chamberlain, CryoTransport Manager Alcor Life Extension Foundation Author’s Notes he format used in this report follows closely that used by Mike Darwin of BioPreservation, Inc. This, and Tthe brevity used to describe events during the washout and cryoperfusion, was done in order to make it easier for those who will be using these technical reports in efforts to improve CryoTransport (both transport and preservation) protocols. This technical report was sent out for review and comment prior to publication. Special thanks is given to Hugh Hixon of Alcor and to Mike Darwin of BioPreservation, Inc. for comments and suggestions which improved both the form and substance of this report. CryoTransport can be broken down into three major areas: (1) Remote rescue and transport to Alcor, which includes patient acquisition and stabilization, (2) Cryoprotective Perfusion, and (3) Cooldown and Long-Term Care. This report covers all areas except long-term care, which is just beginning. Background History progress of his disease, however, al- and Synopsis lowed two members of Alcor’s Mr. Kuhrt was one of the earli- CryoTransport Team (Linda Cham- est members of a cryonics organiza- berlain and Tanya Jones) to visit tion. In a LifePact interview made Long Island several weeks in ad- in the hospital several weeks before vance of his cardiopulmonary arrest his cardiopulmonary arrest, Mr. in order to make arrangements with Kuhrt told me many interesting sto- his oncologist, the hospital, and a ries about his early involvement with cooperating funeral home. cryonics. In the mid 1970’s, news- The oncologist and Mather Me- papers ran an article about the morial Hospital in Port Jefferson, Cryonics Society of New York and Long Island, were very supportive about how cryonics was being and gave Alcor unprecedented as- funded by life insurance. Insurance sistance. The positive, cooperative companies were concerned CSNY attitude displayed by the entire nurs- might be fraudulently selling insur- ing staff comforted Mr. Kuhrt’s fam- ance policies. As a private investi- Edward W. Kuhrt ily and proved invaluable to Alcor gator, Mr. Kuhrt was retained to look Date of Birth: December 28, 1931 during its remote standby and trans- into this. To their surprise, he was Date of Biostasis: February 8, 1997 port. himself a member. He assured the At the time of arrest, a code team insurance industry that cryonics was nal, Mr. Kuhrt expressed a desire to was called from the emergency room legitimate. Mr. Kuhrt and his wife move to Scottsdale, Arizona to be and cardiopulmonary resuscitation became Alcor members in June, close to Alcor when he experienced began, along with administration of 1986. cardiopulmonary arrest. heparin, sodium bicarbonate, strep- In January of 1997, Mr. Kuhrt Due to insurance (HMO) rules, tokinase, and Maalox (through gas- was diagnosed with an aggressive and the loss of strength resulting tric tube). After the emergency room form of lung cancer that had already from his radiation treatments, Mr. personnel finished this initial proto- metastasized to the bones. Upon Kuhrt was not able to relocate to col, Alcor personnel continued car- learning that his cancer was termi- Arizona. The relatively slow diac compression, packed Mr. Kuhrt 2nd Qtr, 1997 • Cryonics 27 in ice, and delivered additional medi- q.d. for hypertension. men due to ascites (cause as yet not cations to limit ischemic damage and On January 6, 1997, at the age known). While we were there, Mr. stabilize cell membranes. of 65, Mr. Kuhrt was admitted to Kuhrt’s morphine level was doubled The patient was then transferred Mather Memorial Hospital, Port in an effort to maintain his comfort. to the funeral home for whole-body Jefferson, NY, for right-hip pain that The day after returning from the washout before being shipped by air had been problematic for several reconnaissance trip (January 18, to Scottsdale for cryoperfusion and months. Examination was performed 1997) the author called the patient’s long-term storage. Mr. Kuhrt’s long with markers [sic] to include the wife, Anne Kuhrt. Mr. Kuhrt’s level acquaintance with both cryonics and right hip, the proximal shaft right of consciousness (LOC) had de- Alcor, as well as his aggressive in- femur and the right iliac bone, the clined remarkably; he remembered volvement in his own care — par- ischial bone and the pubic bone. Mr. that we had been there, but did not ticularly as it related to his impend- Kuhrt was diagnosed as having appear to understand the purpose of ing cryonic suspension — estab- metastatic non-small cell lung can- our trip. Mr. Kuhrt did not even lished his informed consent. Both cer. Palliative radiation was pre- remember that his cancer was ter- the washout and perfusion went well. scribed to slow tumor growth and minal. The increased morphine was Full details follow. manage pain. Blood transfusions making a marked difference in his were also given. LOC. Medical History During a logistics trip to Long (Although repeated attempts Island (to make arrangements with Cardiopulmonary Arrest have been made to acquire full medi- a funeral director, the oncologist, The oncologist had planned to cal records, to date such records have and the hospital), we observed that implant an abdominal morphine not been received. The medical his- Mr. Kuhrt had a normal level of pump on February 5, 1997, but be- tory below is, at the time of this consciousness, his spirits were high fore this could be done the patient publication, still limited and was pri- at being visited by Alcor members, experienced abdominal bleeding that marily gained through personal con- and he was eager and happy to talk brought on an emergency requiring versations with family members.) about his cryonics arrangements and intubation and artificial respiration. Mr. Kuhrt smoked two packs of his hopes for re-entry and rehabili- Mr. Kuhrt was no longer a candi- cigarettes per day since 1945 (52 tation. Nonetheless, he was obvi- date for the abdominal pump and years). In 1987 he was diagnosed ously in pain and tired easily. The had come very close to cardiopul- with colon cancer and received a patient’s circulation in both legs was monary arrest. colostomy. In 1995 he was diag- badly compromised by tumors in his Anne Kuhrt called Alcor with nosed with Type II, adult onset dia- hips and buttocks. Premortem signs this information. After discussing the betes. Mr. Kuhrt’s diabetes was man- included almost total lack of color, situation with the nurse on duty, it aged with 2000 mg. of Glucophage lack of pedal pulse at either the was decided that the transport team q.d., and 40 mg. Glucotrol q.d. The dorsalis pedis or posterior tibial, and should be deployed as soon as pos- patient also took 20 mg. of Zestril a greatly distended and rigid abdo- sible the next day. morphine Date Time Pulse Resp/Min Temp (°F) Skin condition drips/minute ____________________________________________________________________________________ 2-5-97 10 2-6-97 100-110 12-14 97 cool, dry, grey 12 2-7-97 19:39 104 14 101.7 warm, dry 14 21:12 BP = 98/58 16 22:50 116 12 97.3 warm, dry 16 2-8-97 12:17 20 03:57 weak, labored cool, damp 26 ___________________________________________________________________________________ Figure 1: Agonal Course Vital Signs 28 Cryonics • 2nd Qtr, 1997 The transport team arrived on the evening of February 6, 1997. Time: Medication Administered: Mr. Kuhrt was experiencing un- ____________________________________________________________ controllable pain and was not able no record 60,000 IU heparin (for anticoagulation) to communicate well, but he did 04:34 120,000 IU streptokinase (lysis of hemostatic fibrin ) seem to recognize and respond no record 250 cc Maalox (to neutralize gastric hydrochloric acid) positively to the two team mem- 04:37 700 mEq sodium bicarbonate (to combat acidosis) bers who had met previously 04:40 patient’s head packed with ice bags (Linda Chamberlain and Tanya ____________________________________________________________ Jones). CryoTransport medica- Figure 2: Medications Administered by Hospital Personnel. tions were drawn and put on ice, and washout equipment was set up medications. After saying farewell February 8, 1997, the patient was at the mortuary. (For Vital Signs, to Mr. Kuhrt and his family, the attended by his son, daughter, and see Figure 1.) Alcor team retired to a nearby lounge daughter-in-law. As the patient’s Mr. Kuhrt and his family (wife, at 10:00 PM. Thereafter, Linda level of consciousness (LOC) had son, and daughter, their respective Chamberlain checked the patient ap- been declining over the early morn- spouses, and Anne’s two sisters) re- proximately once per hour. The ing hours, they were watching him quested that medical life support ef- patient’s son and daughter-in-law closely. When his rate of respira- forts be terminated. On doctor’s or- remained at his bedside. tions dropped to less than 1 per 15 ders, at 11:19 AM on February 7, seconds, they summoned the Alcor 1997, the nursing staff discontinued Remote Transport: team and the attending nurse. When the IV insulin drip. The patient was CPR, Medication, and Initial, the author arrived in the patient’s kept on oxygen, and his morphine External Cooling room, the nurse was ascultating the was increased. The patient’s urine Participants: patient’s chest for lung sounds. The output (to Foley catheter) was nearly Steve Bridge, Logistics author stepped out into the hall to nonexistent; extant urine was dark Fred Chamberlain, Logistics talk with other team members and brown. Linda Chamberlain, Transport team heard the code called. The nursing staff agreed to leave Hugh Hixon, Transport team An Emergency Room code team the patient’s subclavian catheter and Tanya Jones, Transport Manager responded, took an EKG, and pro- nasogastric tube in place for the ad- nounced the patient at 04:25 EST.
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