Peter Safar, M.D., dies at 79

University of Pittsburgh Medical Center, August 4, 2003

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PITTSBURGH, Aug. 4 - Peter Safar, M.D., Distinguished Professor of Resuscitation Medicine at the University of Pittsburgh School of Medicine, died last night. He was 79 years old. He is survived by his wife Eva, and two sons, Philip and Paul. A third child, Elizabeth, died in 1966.

Known as the father of modern day cardiopulmonary resuscitation (CPR), Dr. Safar's research efforts and accomplishments in emergency medicine, critical care medicine, resuscitation research and disaster re-animatology have saved many lives and gained international recognition.

"Throughout his distinguished career, Peter Safar worked tirelessly and effectively to cheat death," said University of Pittsburgh Chancellor Mark Nordenberg. "He fundamentally re-shaped approaches to medical treatment and helped save hundreds of thousands of lives. His own life was characterized by intellectual power, uncompromising standards and personal grace. He was one of a kind and will be sorely missed by his friends and colleagues, here and around the world."

"Peter Safar was an incredible man who not only saved a countless number of lives through his work but influenced generations through his genius, elegance, humanism and remarkable purpose. I don't think a day went by that Peter didn't do something good for mankind," said Patrick Kochanek, M.D., director of the Safar Center for Resuscitation Research at the University of Pittsburgh.

Dr. Safar was born in 1924 in Vienna, Austria. After brief studies in pathology research, oncology and surgery at the University of Vienna (1948-49) and Yale University (1949-50), he received his anesthesiology training at the University of Pennsylvania in 1950-52.

He initiated, developed and chaired academic anesthesiology departments in three institutions: the National Cancer Institute in Lima, Peru (1952-53), Baltimore City Hospital (BCH, now Johns Hopkins Bayview Medical Center) (1955-61) and the University of Pittsburgh Medical Center (UPMC) (1961-78).

Dr. Safar and associates developed the department at UPMC into the largest academic anesthesiology department in the United States, which from 1962 to 1999 gave critical care medicine training to more than 500 physicians. The department fathered 10 new programs in anesthesiology, pain control, respiratory therapy, intensive (critical) care medicine, emergency medical services, resuscitation research and disaster reanimatology.

Dr. Safar was clinically active as an anesthesiologist for 39 years, until age 65. In 1979 at the age of 55, he stepped aside as department chairman. That same year, Dr. Safar founded the International Resuscitation Research Center (IRRC) at the University Pittsburgh, which he directed until 1994. He mentored 60 physicians and 20 medical student research fellows at the IRRC.

In 1994, at the age of 70, Dr. Safar turned the IRRC leadership over to Patrick Kochanek, M.D., who renamed the IRRC, the Safar Center for Resuscitation Research (SCRR). Dr. Safar continued to lead research programs on cardiac arrest, traumatology and suspended animation.

In the 1950s, at Baltimore City Hospital, Dr. Safar documented, with experiments on human volunteers, cardiopulmonary resuscitation (CPR) step A (airway control by backward tilt of the head, jaw thrust and open mouth) and step B (the superiority of mouth-to-mouth over manual artificial ventilation). He combined steps A and B with step C (closed-chest cardiac massage, rediscovered and documented by others) into basic life support (BLS).

In 1961, Safar extended CPR into cardiopulmonary-cerebral resuscitation (CPCR), which he assembled as a sequence of nine steps of basic, advanced and prolonged life support (BLS-ALS-PLS). He co-initiated modern life supporting first aid (LSFA), resuscitation and intensive (critical) care medicine (CCM).

He initiated and developed the first medical-surgical physician-staffed intensive care unit (ICU) in the United States in 1958 at BCH and the first multidisciplinary critical care medicine physician fellowship training program in the world in 1962 at UPMC. He created the first guidelines for community-wide emergency medical services (EMS).

In the 1960s, Dr. Safar was a founding member of the American Heart Association's CPR Committee and the U.S. National Research Council's Committee on EMS. He helped initiate the first guidelines on CPR, ambulance design and equipment and emergency medical technician and paramedic training. His group conducted the first CPR education research.

In the 1970s, he began disaster reanimatology research. Starting in 1970, he established research programs into cerebral resuscitation from prolonged cardiac arrest. Since then Dr. Safar and his colleagues developed and used novel models in large animal models, with intensive care and outcome evaluation. This year the World Association for Disaster Medicine named its annual award in Dr. Safar's honor.

In 1979, he began and developed the first controlled international multicenter mechanism for clinical studies of sudden death and CPCR, the "Brain Resuscitation Clinical Trial (BRCT)" conducted by 20 teams in seven countries and funded for 15 consecutive years by the National Institutes of Health.

In the 1980s, his group began research, which had been dormant for 25 years, into resuscitative (post-insult) hypothermia and discovered the efficacy of mild therapeutic hypothermia for cardiac arrest and shock in animal models. Recently, mild therapeutic hypothermia received a level one recommendation for use in cardiac arrest by the American Heart Association.

Dr. Safar had been active in "peace medicine" and addressed "roots of wars" and human rights. His alumni and past and present associates include more than 100 professors and researchers worldwide in anesthesiology or various fields of acute medicine.

His professional publications include 1,389 entries, including 384 peer reviewed original publications, more than 30 books and manuals and more than 600 abstracts. He had been author, editor or co-editor of the first textbooks on respiratory therapy, public health considerations in CCM and anesthesiology, CPCR and emergency medicine. Since the 1960s, he authored the international CPCR guidelines book sponsored by the World Federation of Societies of Anesthesiologists (WFSA), co-initiated the journal Critical Care Medicine (1972), initiated the journal Prehospital and Disaster Medicine (1982), and wrote autobiographic memoirs in a book by the American Society of Anesthesiologists (2000).

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