Aware study progress (and more oxygenation musing)

As of writing Jan 2016, the UKCRN website (http://public.ukcrn.org.uk/search/StudyDetail.aspx?StudyID=17129) states that 3% of the study data pool has been achieved, or in the exact wording “global recruitment to date”. (EDIT: Please note as of late 2016 the details of this study outline have been removed and the link is no longer valid. There is a new official briefing page on the NHS Research portal  http://www.hra.nhs.uk/news/research-summaries/aware-ii). The study start appears to have been started in May 2015, meaning that if the proposed time duration has to be adhered to, as stated ending May 2017, the likely final pool will only be 12% of what was hoped for, or approximately 180 patients recruited. I take this to infer the number of survivors of cardiac arrest through resuscitation under the controlled conditions of the study.

This may seem disheartening, especially in the light of statistical probabilities of patient recall, but there may well be good reason for optimism.

One aspect of this study, much discussed on this blog, is the monitoring of oxygen during resuscitation to better assist CPR efforts and give more survivable outcomes. A correlation between better oxygen and NDE recall is part of the research. This should mean that better resuscitation is implemented in the pool of this study, thus hopefully producing better patient outcomes, and maybe then, if the oxygen / recall correlation does exist, a richer rate of experiences is recorded.
So whereas the study from it’s outset is small, the useful data return could still be substantial.

Beyond Correlation

The possible pattern of higher oxygen producing more recall experiences is good for this and future studies, but in itself will have to at some point be questioned and explored for any causality factors. It could be postulated that better recovery and less post arrest damage allows an experience to be imbedded in memory at an earlier stage in recovery, when it is less likely to be lost. But then some of the wording from Dr Parnia and the AWARE team could be read as somewhat leading down a physiological understanding.

“Perhaps the people who had experiences simply had higher oxygen levels of blood flowing into the brain and hence oxygen delivery.”      (Erasing Death)

“It is possible that patients who are able to recount these experiences may have better patient outcomes in terms of reduced brain damage, improved functional ability and better psychological adjustment to the event. We think that these patients may have had better blood flow to the brain during cardiac arrest, leading to consciousness and activity of the mind.”   (UKCRN study outline)

Of course what will help steer this quandary is what could be seen as the holy grail of the whole AWARE project, that is, an experimentally verified visually veridical experience recall. Such a result will have to lead to more than physiological hypotheses. At the very least it would question our understanding of measurable brain activity in relation to actual conscious activity. Indeed, a specifically external visual recall would question the convention of consciousness as a physiological phenomenon entirely.

Having started in May 2015, the current phase of study should finish data collection in May 2017.

Then we wait…..

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2 thoughts on “Aware study progress (and more oxygenation musing)

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