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William Kouwenhoven

William B. Kouwenhoven

William Bennet Kouwenhoven (13 January 1886 – 10 November 1975), also known as the "father of cardiopulmonary resuscitation (CPR),” is famous for his development of the closed-chest cardiac massage and his invention of the cardiac defibrillator. After obtaining his doctorate degree in engineering from the Karlsruhe Technische Hochschule in Germany, Kouwenhoven began his career as the dean of at the Johns Hopkins University. Kouwenhoven focused his research mainly on improving and saving lives of patients through the application of electricity. With the help and cooperation of the Johns Hopkins Medical School's Department of Surgery and an Edison Electric Institution grant, Kouwenhoven developed a closed-chest defibrillator. For his contributions to the field of medical science, he became the first ever recipient of the honorary degree conferred by the Johns Hopkins School of Medicine. Two years before his death, Kouwenhoven was also awarded the most prestigious biomedical prize: the Albert Lasker Award for Clinical Medical Research.

Biography

William Bennet Kouwenhoven was born in Brooklyn, NY, on January 13, 1886. Kouwenhoven joined the Polytechnic Institute of Brooklyn in 1903. As a college freshman, Kouwenhoven was intrigued by the relationship between electricity and medicine, which later became the topics for his English themes. Three years later, he graduated with a BA in electrical engineering. Then in 1907, he earned his MS in mechanical engineering and began teaching physics and electrical engineering at the institute. In 1910, Kouwenhoven married Abigail Baxter Remsen and traveled to Germany to study at the Karlsruhe Technische Hochschule. After obtaining his doctorate in engineering in 1913, Kouwenhoven moved back to the United States. He then went on to teach engineering at Washington University in St. Louis for a year. In 1914, Kouwenhoven accepted a job as an instructor in the Electrical Engineering department at the Johns Hopkins University. In 1919, he was offered the position of an associate professor, and by 1930 he had been promoted to a full professor. Kpatel1214 (talk) 21:59, 11 March 2017 (UTC)

Career at Johns Hopkins University

In the year 1914, William Kouwenhoven was hired as a professor at Johns Hopkins University’s School of Engineering. His research interests consisted of the effects of electricity on the human body as well as cardiac arrest. By 1919, he worked as an associate professor at Johns Hopkins and was later promoted to full professor in 1930. Due to the success of his research, Kouwenhoven was promoted to an administrative position as the Dean of Johns Hopkins University’s School of Engineering from 1938 to 1954. During this tenure as dean, Kouwenhoven was able to develop and perfect his most famous project on the electric cardiac defibrillator. At the age of 68, William Kouwenhoven retired as dean but continued to focus on his medical research at Hopkins past his retirement. Jcho53 (talk) 16:59, 13 March 2017 (UTC)

Electric Cardiac Defibrillator

Open-Chest Defibrillator

William Kouwenhoven’s research focused on the effects of electricity on the heart, and he wanted to develop an instrument that would revive or shock the heart without invasive surgery. The first procedures were done on rats and dogs, but both investigations failed to produce groundbreaking results. Then, in 1925, the Johns Hopkins School of Hygiene and Public Health was appointed as an exclusive site by the Consolidated Edison of New York to investigate and examine the effects of electricity on the human body. The principal investigator of this Consolidated Edison study, Johns Hopkins neurologist Othello Langworthy, welcomed to his team the professor of electrical engineering - William Kouwenhoven. By 1928, Kouwenhoven and his team were able to observe the effects of DC and AC shock on the heart. They noticed that when low-voltage shocks were applied to the heart, ventricular fibrillation was induced. Kouwenhoven also discovered that high voltage shocks from the electrodes placed on the rats’ heads resulted in the heart to stop pumping blood because the lungs had shut down completely. Another method Kouwenhoven used to revive the hearts of rats was by giving CPR and massaging their chests. However, this failed because massaging the chests resulted in the paralysis of the rats due to their crushed cervical spines. By the year 1933, Kouwenhoven switched his research focus onto dogs. He detected that delivering a second surge of electricity, also known as a countershock, led to the restoration of the sinus rhythm and normal heart contraction. This allowed the dog’s heart, which was in ventricular fibrillation, to beat normally once again; this process of reviving the heart from ventricular fibrillation is now known as defibrillation. The news of Kouwenhoven’s fascinating finding completely altered the approach to cardiac care. Despite the high risks of the procedure, it was used by doctors at Case Western School of Medicine. In 1947, Claude Beck, M.D., became the first surgeon ever to place electrodes directly on a heart that was in ventricular fibrillation during a surgery. Kouwenhoven’s studies also stirred the Division of Anesthesiology at Johns Hopkins School of Medicine. In 1940s, researchers James Elam and Peter Safir perfected the emergency mouth-to-mouth method of lung ventilation, which is essential for oxygenating the blood when the heart is no longer functioning.

Closed-Chest Defibrillator

In 1950, Kouwenhoven began his research on a closed-chest defibrillator. Alfred Blalock, the Chief of Surgery at the time, was dubious at first regarding Kouwenhoven’s ideas. However, he soon agreed to provide laboratory space and equipment for Kouwenhoven’s studies. At first, Kouwenhoven and his team monitored the effect of electrodes on the opposite sides of the chest. They noted that a brief AC current of 20 amperes was able to jolt a heart from ventricular fibrillation back into a normal sinus rhythm. Samuel Talbot, a surgeon who was studying heart arrhythmias in dogs at the time, asked Kouwenhoven to merge his research on a defibrillator with Talbot’s studies. Afterwards, Kouwenhoven observed that the current flowed best vertically instead of horizontally when passed through a dog’s heart. By noticing this, he was able to decrease the shock’s intensity by 50 percent.

By 1957, Kouwenhoven and his team had designed a prototype specifically to work on humans. This novel device weighed approximately 200 pounds and consisted of a small box with two insulated cables with copper electrodes, which administered an AC current. One electrode was to be placed over the suprasternal notch, and the other electrode was to be placed over the apex of the heart. Guy Knickerbocker, an electrical engineer working at Kouwenhoven’s laboratory, discovered that the copper electrodes caused a rise in blood pressure in the rest of the body when they were pressed down onto a dog’s chest even before the current was passed through them. He hypothesized that massaging the chest in a rhythmical manner causes the blood to circulate. This observation paved the path for the third major discovery by Kouwenhoven’s team: cardiopulmonary resuscitation also known as CPR.. In 1969, Kouwenhoven became the first ever recipient of an honorary degree presented by the Johns Hopkins School of Medicine for his contributions to the medical science. Two years before his death, in 1973, Kouwenhoven was presented with the most prestigious biomedical prize in America: the Albert Lasker Award for Clinical Medical Research. When he passed away in 1975, the New York Time obituary recognized Kouwenhoven’s accomplishments and contributions by stating that he had “developed the basic cardiac treatment devices and procedures used worldwide.”Kpatel1214 (talk) 21:59, 11 March 2017 (UTC)

In Kouwenhoven’s honor and memory, the Whiting School of Engineering at Johns Hopkins University established the William B. Kouwenhoven Professorship in Electrical Engineering in 1981. The current holder of this Kouwenhoven Professorship is Jerry L. Prince, the associate director for research at the Center of Computer Integrated Surgical Systems and Technology. Prince has worked on co-developing HARP MRI, which provides doctors with the ability to assess the condition of heart muscles within seconds. He is also currently researching image processing and computer vision with primary application to medical imaging. Kpatel1214 (talk) 21:59, 11 March 2017 (UTC)

Meeting the Real Kouwenhoven

Nick Kouwenhoven, the grandson of William B. Kouwenhoven and the son of William G. Kouwenhoven, manages products for the wireless and cellular telephone industry, Tessco Technologies.

"My grandfather was an extremely intense and competitive man. When...we used to play dominoes...he had no qualms about destroying me in a game; for him...that's how you played - to win. As a teacher, he was known for being demanding, but I also have learned that he secretly paid for kids who showed promise to go to school. But he never made anything of that.

"He was tough, tenacious - demanding excellence at every point.

Gil Kaisler graduated with his BS in mechanical engineering from Hopkins in 1944. After returning to Baltimore from his stint in Navy, he began working for Western Electricity. In 1952, Kaisler earned his second BS in electrical engineering and joined Kouwenhoven's team.

"While working in the research department, I studied electrical shocks and hazards...One day, my boss called me to his office and asked me, 'What is the smallest protable AC generator you can come up with?'

"I recommended that we use ten 45-volt radio batteries and eight electrolytic capacitors...which amounted to about 200 joules...Dr. Franklin had an anesthetized dog on its back and gave it a shock, fibrillating the heart. Then he used my device, and on the third try, it stopped the fibrillation, and the heart resumed beating normally.

"Dr. Kouwenhoven had the great idea to stop the fibrillating heart and then restart it. I merely gave him the tool to do it, by developing the circuitry."

Kpatel1214 (talk) 16:38, 16 April 2017 (UTC)