John J Osborn

John J Osborn (1917 – 2014)

John J Osborn (1917 – 2014) was an American intensivist, pediatrician and inventor.

Extensive work on hypothermia and describing a ‘current of injury‘ that bears his name – the Osborn wave – 1953

Refined the use of the ‘heart-lung machine‘ with Dr. Gerbode and the Stanford cardiothoracic team

Introduced and refined continuous haemodynamic computer monitoring of postoperative cardiac patients and was at the forefront of the development of the intensive car unit.

Osborn published over 130 papers although he considered ‘only three or four of these to be of any importance.’

Biography

  • Born 5 November 1917
  • 1937 – Undergraduate degree Biology, Princeton University
  • 1943 – Graduated Medical school, Johns Hopkins
  • WW II – Army medical officer for a field artillery battalions
  • 1946 – Assistant Professor of Pediatrics, New York University College of Medicine
  • 1954 – Stanford University
  • 1970 – Founding member of the Society of Critical Care Medicine
  • 1978 – Retired form clinical practice to run his company ‘Research Development Corporation’ (later sold to Johnson & Johnson) to develop and manufacture intensive care unit monitoring devices
  • Died 25 April 2014

Key Medical Attributions

Hypothermia and waves

  • 1943 – Interest in hypothermia at medical school, challenging the accepted notion that warm-blooded mammals could not survive deep hypothermia. He cooled anesthetized dogs to 5°C, left them without circulation for an hour and then rewarmed them. He restored heartbeat with open cardiac massage and a defibrillator consisting of two spoons with insulated handles, connected directly through a knifeswitch to an electrical wall outlet. Although none of the animals survived, he was able to demonstrate brain activity after rewarming
  • 1953 – Experimentally-induced hypothermia caused the development of a distinct deflection at the J point on the ECG and resulted in ventricular fibrillation. He called this deflection the ‘current of injury’.
  • 1998 – In an interview Osborn admitted that his 1953 article, in which he described the Osborn wave, had erroneous blood pH calculations because he used the wrong temperature corrections. His miscalculations were discovered by John W. Severinghaus, known for developing the Severinghaus electrode and the first blood gas analyzer

Heart-lung machine

  • 1953John Heysham Gibbon (1903-1973) performed the first successful operation on a human using his heart-lung machine.
  • 1954 – working in Stanford, Osborn added a rotating disc oxygenator and heat exchanger to improve efficiency
  • 1956 – Osborn modified machine used by cardiac surgeon Frank Gerbode to repair VSD in the ‘first successful heart-lung bypass procedure west of the Mississippi
  • 1960 – Osborn recommended ‘As a minimum, every part which can possibly touch blood should be scrubbed individually with appropriate detergent, then rinsed long and hard. All parts should be dried and coated with baked silicone before each use‘. Osborn stressed the need for a good blood filter to reduce the post-operative complications of delirium and cerebral emboli, initially using the Swank filter developed by Dr. Roy Swank at Oregon.

Medical Eponyms


Major Publications

  • Osborn JJ. Experimental hypothermia; respiratory and blood pH changes in relation to cardiac function. Am J Physiol. 1953 Dec;175(3):389-98. [PMID 13114420]
  • Osborn JJ, Bramson ML, Gerbode F. A rotating disc blood oxygenator and integral heat exchanger of improved inherent efficiency. J Thorac Cardiovasc Surg. 1960 Apr;39:427-37. [PMID 14429188]
  • Osborn JJ, Fagan LM, Fallat RJ, Kunz JC, McClung DH, Mitchell RR. Managing the data from respiratory measurements. Med Instrum. 1979 Nov-Dec;13(6):330-6. [PMID 522716]
  • Osborn JJ. Computers in critical care medicine: promises and pitfalls. Crit Care Med. 1982 Dec;10(12):807-10. [PMID 7140327]

References

  • Partin C. John J. Osborn. Clin Cardiol. 1998 Jan;21(1):66-8. [PMID 9474470]

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Posted by Dr Mike Cadogan

Emergency physician with a passion for medical informatics and medical education/textbooks. Asynchronous learning #FOAMed evangelist | @sandnsurf | + Mike Cadogan | LinkedIn

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