John J Osborn

John J Osborn (1917 – 2014)

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

Extensive work on hypothermic animals in 1953 allowed him to bear his name on the Osborn wave – what he described as a ‘current of injury‘ heralding impending ventricular fibrillation.

He developed and refined his ‘heart-lung machine‘ with Dr. Gerbode and the Stanford cardiothoracic team.

Osborn introduced and continuous hemodynamic computer monitoring of postoperative cardiac patients and was at the forefront of the development of the intensive care unit.

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


Biography
  • 1917 – Born November 5
  • 1937 – Undergraduate degree in Biology, Princeton University
  • 1943 – Graduated Medical school, Johns Hopkins
  • 1944 – Pediatric residency
  • 1945 – Army medical officer for a field artillery battalion in Philippines
  • 1946 – Assistant Professor of Pediatrics, New York University College of Medicine
  • 1954 – Intensivist at 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
  • 2014 – Died April 25

Medical Eponyms
Osborn wave (J wave) (1953)

Initially described as a ‘current of injury’, the Osborn wave (J wave) is a positive deflection at the J point (negative in aVR and V1). It is usually most prominent in the precordial leads

ECG J point J wave J point elevation
J point in a) normal; b) c) J point elevation; d) J point depression; e) with J wave (Osborn wave)

1953 – Osborn studied the effect of hypothermia on the respiratory and cardiac function in dogs. 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’. [Osborn JJ. Am J Physiol. 1953 Dec;175(3):389-98]

Osborn Current of Injury

Osborn considered acidaemia induced by hypothermia as a primary cause of the Osborn wave, because it disappeared if the arterial pH was normalized by hyperventilation during the same degree of cooling

1959 Emslie-Smith (British Heart Journal, …changes in the ECG in hypothermia.) ‘The characteristic deflection of hypothermia has sometimes been named after Osborm who discussed it in 1953.’


Key Medical Attributions
Hypothermia and waves

1943 – Osborn became interested in hypothermia at medical school, whereby he challenged 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 their heartbeats with open cardiac massage and a homemade defibrillator. None of the animals survived, but 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 exchange to improve efficiency.

1956 – Osborn modified machine used by cardiac surgeon Frank Gerbode to repair a ventral septal defect in the ‘first successful heart-lung bypass procedure west of the Mississippi‘. At the time, this machine cost $3000.

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 in Oregon.


Major Publications

References

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the person behind the name

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

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