Редактирование: Cryopreservation (раздел)

== Pre Arrest ==

=== Standby ===

'''Alcor''' has teams of volunteers all over the United States trained to stand by a patient, apply anticoagulants and CPR, and transport the patient until proper cardiopulmonary support can be secured.

[[#Suspended Animation|Suspended Animation]] (The company) has an equipped ambulance that is used to stabilize and transport Alcor and CI patients (Of the latter, only those who have explicitly made arrangements with SA). In some cases, a charter jet has to be used to transport the patients.

=== Pretreatment ===

The rationale of pharmacological pre-treatment is that cryonics Patients should not have to wait until legal death before application of anti-coagulant and anti-oxidant medications, when much higher levels in blood and tissue can be achieved if these are administered prior to legal death.

The three objectives of pre-treatment are
* '''Prevent Clotting:''' Reducing clotting is of great benefit, as it the reason why Heparin is universally applied after legal death. Clotting prevents proper cryoprotective perfusion. In cases where the patient is undergoing surgery, however, clotting is desired, and as such anti-coagulants cannot be administered.
* '''Prevent Edema:''' Edematous tissue has the same adverse effects as clotting: Edema constricts blood vessels, sealing large volumes of tissue away from cryoprotectant solutions.
* '''Prevent Ischmemia:''' When tissue is deprived of blood flow (And thus Oxygen), especially brain tissue, large amounts of damage occur. Excessive cerebral ischemia can make the best cryonics effort useless, due to the loss of fundamental properties of brain tissue and by causing edema.

'''Drugs:'''

* '''Alpha-tocopherol Form of Vitamin E:'''
** '''Administration & Dose:''' IV, 20mg/kg, 30 minutes prior to ischemia.
** Has been shown to significantly reduce lipid peroxidation and neurological damage <ref>STROKE 14(6):977-982 (1983)</ref>
** has the additional advantage of reducing blood clotting
** does not have the risk of gastric bleeding associated with aspirin
* '''Fish Oil (especially salmon oil):'''
** Same benefits as the above.
** reducing the risk of cardiac arrest <ref>MOLECULAR AND CELLULAR BIOCHEMISTRY 116(1-2):19-25 (1992)</ref>.
* '''Lipoic Acid:'''
** is beneficial in reducing ischemic-reperfusion injury by direct action as well as by glutathione protection and xanthine oxidase inhibition<ref>FREE RADICAL BIOLOGY & MEDICINE; Packer, L.; 19(2):227-250 (1995)</ref>.

* '''CoEnzyme Q10:'''
** has been shown to protect rat endothelial cells from ischemia & reperfusion injury<ref>SURGERY; Yokoyama,H; 120(2):189-196 (1996)</ref>.
** Human cardiac arrest patients admitted to a hospital within 6 hours of cardiac arrest given a 250 mg loading dose of CoQ10 showed 68% survival compared to 30% of controls.
**  Of the survivors, 36% of the CoQ10 group had good neurological outcome, in contrast to 20% of controls <ref>CIRCULATION; Damian,MS; 110(19):3011-3016 (2004)</ref>.

* '''N-acetylcysteine:'''
** '''Dose:''' 15 grams.
** When infused in human myocardial infarction patients over a 24-hour period it significantly reduced ischemic damage<ref>CIRCULATION 92(10):2855-2862 (1995)</ref>.

* '''Curcumin:'''
** This phytochemical is powerful antioxidant which is several times more potent than Vitamin E<ref>THE JOURNAL OF NEUROSCIENCE 21(21):8370-8377 (2001)</ref>
Vitamin C should '''not''' be used for ischemia/reperfusion pretreatment. While normally it is an anti-oxidant, it becomes a powerful pro-oxidant in the presence of the metal ions which are released, in large quantities, by ischemic brain tissue.

* '''Summary:''' (For patients weighing 100 kilograms)
** '''Alpha Lipoic Acid:''' 600mg per day of the R form, or 1000mg of the Racemic form.
** '''CoEnzyme Q10:''' 500mg per day.
** '''Tocopherol''': 2,000 IU per day (Equal amounts of alpha and gamma).