3 ms·

I've read a little about the "Dobkin Technique" where a cold compress is held over the eyes and face of a patient in cardiac arrest to simulate the 'mammalian d

by paulse 9y ago

I've read a little about the "Dobkin Technique" where a cold compress is held over the eyes and face of a patient in cardiac arrest to simulate the 'mammalian diving reflex' and delay brain death like shown in these cases. Is there any truth to this or is it pseudoscience? Why wouldn't this be a more known treatment if it works?

pacaro 9y ago
I have no idea about the treatment you describe, but the mammalian dive reflex is very real, and is a useful way to induce bradycardia. For example, splashing cold water on your face can legitimately help with a panic attack
dumbneurologist 9y ago
the diving reflex is real, and is used clinically to treat supraventricular tachycardia (where a re-entrant electrical feedback loop in the heart can be broken by slowing down the choke-point through which it passes). It slows down the heart and lessens its contractile power consumption. That could conceivably work (in my mind) after a cardiac arrest, but it isn't really related to brain death (which is an issue in the days and weeks following, in the ICU where oxygenation and glucose usually plentiful). Remember: the "theory" behind any medical idea is almost irrelevant if you have data regarding the outcome. If you have outcome data, it supercedes the theory, and is all-important. The theory simply helps us prioritize which treatments to assess first - the better the fundamentals, the more worthy it is of scarce research resources. That's one of my biggest criticisms of the lay press: they emphasize the scientific narrative and don't focus enough on the outcomes. The most meaningful outcomes in scientific terms always mean the same thing: a meaningful improvement by blinded observer in something we care about. "meaningful improvement" - this means that improving survival by a tenth of one percent might not be worth the trouble of implementation "blinded observer" - because it cancels out the placebo effect and expectations "something we care about" - such as returning to school. But if you do a SPECT scan and the SPECT scan "looks better" to the doctor? That's not important. We sometimes use things that are well-documented to reflect important things even though they are not important in their own right... we call these biomarkers.

by paulse 9y ago

pacaro 9y ago

I have no idea about the treatment you describe, but the mammalian dive reflex is very real, and is a useful way to induce bradycardia. For example, splashing cold water on your face can legitimately help with a panic attack

dumbneurologist 9y ago

the diving reflex is real, and is used clinically to treat supraventricular tachycardia (where a re-entrant electrical feedback loop in the heart can be broken by slowing down the choke-point through which it passes). It slows down the heart and lessens its contractile power consumption. That could conceivably work (in my mind) after a cardiac arrest, but it isn't really related to brain death (which is an issue in the days and weeks following, in the ICU where oxygenation and glucose usually plentiful). Remember: the "theory" behind any medical idea is almost irrelevant if you have data regarding the outcome. If you have outcome data, it supercedes the theory, and is all-important. The theory simply helps us prioritize which treatments to assess first - the better the fundamentals, the more worthy it is of scarce research resources. That's one of my biggest criticisms of the lay press: they emphasize the scientific narrative and don't focus enough on the outcomes. The most meaningful outcomes in scientific terms always mean the same thing: a meaningful improvement by blinded observer in something we care about. "meaningful improvement" - this means that improving survival by a tenth of one percent might not be worth the trouble of implementation "blinded observer" - because it cancels out the placebo effect and expectations "something we care about" - such as returning to school. But if you do a SPECT scan and the SPECT scan "looks better" to the doctor? That's not important. We sometimes use things that are well-documented to reflect important things even though they are not important in their own right... we call these biomarkers.