This has been germinating in my mind for a while now but that 'torso thread has kinda spurred it along.

IANADoctor but I know some of you guys are. Are there not better ways to protect and enhance the human body given the things that can be done with cyberware in SR?

In particular I was thinking about blood loss, I'm given to understand that a great many deaths result from straight out exsanguination. Would a cyber system targeted at preventing and mitigating blood loss not be a far better implant than a Pain Editor for example?

You could weave some sort of sheath around all the major blood vessels, insert valves that prevent massive losses, build in redundancy with extra vessels, etc, etc.

Cyber Torsos and Skulls seem like a missed opportunity here also. Once you've controlled blood loss, sticking hardened armour around all the major organs seems like a pretty good idea. You wouldn't be invincible but you could survive almost any kinetic event. Your limbs might be mangled beyond repair but you could survive until Doc-wagon arrived.

Anybody else got any ideas? What would you do to alter and improve the human body given the base technology available in SR?

Isn't there a thing called blood circuit control system in Augmentation? (or something similar? I'm AFB at the moment)

-CJ

The things you mention already exist; there are various mods that restrict blood loss, either by better clotting (Platelet Factories), or constricting bloodvessels that are losing blood.

Cyberskull/Torso: you can put Armor on those.

I suppose there could be a case for Internal Armor or something, but that's tricky. I'm not so sure it'd work all that well, really; most organs cushion each other. Putting hard barriers aroun them might actually increase damage from shaking and battering against the hard barriers.

Good catch.

Don't know why I missed that.

Probably because the mechanical effect is pointless...

It's more expensive in every way than a Platelet Factory, does the same thing and can't be combined.

From a fluff point of view I'd expect a bigger pay-off too. How much of any abstract injury suffered in SR is blood loss? Having your arm lopped off isn't fatal, just inconvenient, but the blood loss will kill you in seconds.

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There's nothing that toughens blood vessels. Preventing damage to them in the first place ought to translate to a massive increase in BOD as every injury is far less likely to result in serious damage.

Incapacitation and death is almost exclusively the result of oxygen starvation (caused by blood loss or pneumothorax) and direct central nervous system hits. So yes, you are by and large correct. The SR system doesn't reflect reality at all - unless you take a CNS hit, most incapacitating hits will still let you operate for 10-12 seconds (ruined heart) to several minutes or hours. Not many just go unconscious from the pain, oxygen starvation from blood loss has to take effect first.




Something like dermal plating is like regular armor a good way of preventing blood loss, by keeping bullets away from blood vessels

I don't really see how you're going to reinforce a blood vessel directly enough that it'll not get torn from a bullet hit.

I'd look at redundancy instead.

Redundant circulatory systems for the major blood vessels in the torso, with the ability to shut down a ruptured system, would make you nearly unstoppable as long as your heart and lungs were working. If you meshed the systems with multiple shut off gates, you'd get massive redundancy.

And an extra heart or two, maybe mechanical, and armor them, and add oxygen tanks to each so you're not dependant on lungs. At the really extreme end, distribute microhearts with oxygen tanks or air intakes and add circulatory overrides that connects arteries and venes locally.

Unless someone puts enough holes in you to knock all the redundant systems, you're pretty much immune to anything but hits to the skull or spine (and of course direct damage to bones and muscles could, ehm, hamper mobility). You could armor the skull and spine, and the spine could also be made redundant, or maybe even go wireless, limiting vulnerability to just the location of the nerve transponders.

You could have your limbs chopped off with such a setup, and everything would still work.

While a BCCS cannot be combined with a Platelet Factory, nothing in Augmentation forbids combination with a Trauma Damper.

Of course, it is still prohibitively expensive Essence-wise and characters who could afford multiple damage soaking ware would usually have to worry more about Stun than Physical damage.

That's where the Pain Editor comes in. It lets you ignore stun modifiers and stay conscious in the event your stun track is filled.

Well, there are tons of problems with your suggestions from a practical standpoint. Replacing all your blood vessels with something 'better' would be absurdly invasive. There are miles and miles of blood vessels in your body. Replacing them all would take ages, and be near impossible simply because they're so omnipresent. And that's not even getting into the difficulty of finding a material that is both tougher and allows for the proper function of your blood vessles.

As for creating secondaries of major vessles, well, that is likely more practical. I'd imagine there might be some space concerns, and you might need to get some muscle upgrades on your heart to handle the extra blood vessels being added. Don't forget that you'd also need a means of determining exactly where you were shot, and which blood vessles are connected to that spot so that the augmentation knows exactly what it should be shutting down. And even then you'd have problems, because depending on how often the cutoffs and reroutes are placed, you could be killing off a large portion of your body. And then there is the issue of major organs being hit in the first place. You can't cut off blood to those or they die and then you die, so it'd just be a choice between dying of blood loss or organ failure.

That said, there are some very interesting new advancements that are already being made. One of which is a new material that can replace blood in trauma patients, which carries more oxygen and moves through the body easier because it is smaller and so isn't constricted. Basically this is being used to get oxygen to the person's brain faster to prevent brain death. I could certainly imagine putting a small reserve of this stuff in you somewhere so that if you start losing blood, this stuff can replace it. Perhaps even a special system in the brain that would keep the brain alive even if the rest of the body dies (basically turning you into a cyborg upon death).

As for armor on major organs - the body is actually better protected by those areas being soft than hard. I suppose you might be slightly more resistant to bullets, but walking down some stairs might cause all kinds of internal problems. Much better to put the armor at skin level.

Perhaps the other reason the things you suggest don't exist, is that they can't be made efficient and non-invasive enough to operate. I mean, why spend 300k nuyen and half your essence to get a bunch of new blood vessels that lessen blood loss, when you can spend 40k and a fraction of your essence to get platelet factories that do the same thing. Why put armor on your internal organs when with a cheaper and less invasive procedure, they can put it on your body? May simply be a case of 'something like that could exist in theory, but in practice, it is so inefficient that no one bothers with it'.

I was thinking Nanites. Program them to locate the relevant vessels and weave some sort of loose fitting sheath around them. Something like Dragon-skin or whatever the 2072 version is.

My point was more what would you do if you were starting from scratch designing a cyberware system using a professional grasp of Medical Science?

There a few similar systems in the current rules set but I don't think they really explore the possibilities or necessarily translate into appropriate crunch.

Ooooohhh. Well, if we're going that route... give me a bit of time when I'm not in class. I'd imagine nanites are the way to go, but remember that they are still fairly new tech, which might be why you don't see that sort of thing yet.

It would be far above the efficiency of platelet factories. Having two circulatory systems would more or less mean you had 2 different physical damage tracks, with hits randomly distributed between them, and only the track with the lowest damage applies (ideally, you'd have to consider CNS hits and hits to both system, especially with autofire, and functional damage to bones, muscles and nerves). You take a hit to a major blood vessel, you switch to to the other circulatory system and are basically not affected by it - now it is just a flesh wound. You take another hit to the first system, no real effect from that either. You then take a fatal hit to your secondary heart, you switch back to the first system (which has two major bleeders, but it is still working).

And that's just the simple secondary system scheme. Having redundancy and the option of re-routing blood flow around bleeders would make you next to unstoppable until you had so many holes in you all your circulatory systems were leaking.

That's good in theory, but it isn't like you can simply jam multiple circulatory systems into your body. There is a space issue first off, and there is the fact that a particular area is going to have to be provided for by every system, which means any given hit will hit all your systems. If you don't do this, then shutting off one system would kill off half your body. What could work is the ability to cut off circulation to an entire portion of the body, like the arm for example, so that if your arm gets cut off or severely damaged, you wouldn't lose much blood for it, but you'd be sacrificing the entire arm. I doubt that the human body has enough space in it for two (let alone dozens of) circulatory systems. And dozens would be required to allow you to bypasses specific spots on your body without cutting off entire areas. You'd basically get instant tourniquets.

The old Question wether certain cyber should give body, armor or both? O.o

You'd only have to do it for major blood vessels. It takes forever to bleed out unless you hit one of those. Shut-offs for non-essential internal organs that can bleed badly and a redundant heart-lung setup, and you're looking at something that pretty much only branches out to 2x6 vessels (arteries and veins, 2 for the head and 1 for each limb).

I suppose that's true, though you'd generally have trouble putting in a second set of those that aren't right next to the original, and even if you managed that, you'd still lose alot of blood because all the blood between the two cutoff points would still be lost. Also have trouble with the heart being able to pump through the extra distance I imagine, though that wouldn't be so bad.

As for an additional heart/lung, now you're really getting into space issues of the human body.

Like I said, my theory is more that it is too invasive. Perhaps what you are talking about could in theory be done, but it would take 6+ essence to do so. Or it could be done, and in theory sounds good, but in practice doesn't give nearly as large of a benefit as you would think (Trust me, I know allll about this). I think you were more on to something with the nanites, but maybe that is just because I love nanites. I could envision them forming instant blood clots whereever they detect wounds if they are everywhere in your blood. I'd imagine if a 5th edition ever comes out, we'll see alot more focus on nano and geneware, just like 4th has had a much greater focus on bioware.

Oh, by the way, everyone should totally try and get their hands on a copy of 2057 by discovery channel. It is truly awesome, and even has a very distinctive SR feel to it (Which is weird since it is a documentary). They literally print hearts for people. They also pull a totally SR style operation. Haven't gotten around to watching the other 2/3rds of it yet though.

I have a few ideas I could interject, but I'm at work and it would be a royal pain to tap this out on an iPhone. I also want to review the fluff for existing trauma ware. I'll post in a few hours when I get home.

Not that this has any effect on getting shot within the rules, but isn't this exactly what Oxyrush Nanoware is for? It lets you hold your breath for half an hour per rating point, so clearly, your lungs aren't being used to get oxygen from point a to point b. The nannies do it instead.

Also, I believe the Trauma Control System does something similiar, in that it protects most vital organs in the course of doing its job.

Well I was thinking about writing a detailed post correlating RL trauma to SR game mechanics, but I realized it is much more expansive then I thought, and I need to think more on the subject.

However, I'll throw out a few random thoughts:

IRL immediate mortality from trauma is basically caused by four things:
-- massive poly trauma: i.e.- the sum of your organic matter isn't left in close enough proximity to support life. (Examples would include stepping on a land mine, being sheered in half at the waist, being crushed by a boulder, etc.)
-- direct trauma to the central nervous system: i.e.- brain or spine
-- massive exsanguination / shock (also a major cause of intermediate mortality usually in the form of solid organ [liver and spleen] laceration or pelvic bleeding)
-- tamponade physiology: i.e.- pneumo/hemothorax or hemopericardium. These increase the pressure in the thoracic cavity or pericardial sac (respectively) until the heart cannot fill properly.

On the big bad list, massive polytrauma and direct CNS damage you can't really fix with cyberware. Armored cyber skull and torso might help for CNS damage, but thats about it.

Tamponde physiology could be prevented by implanting simple one-way valves in, the chest wall for pneumo/hemothorax and a shunt in the pericardium.

But yeah, the real money is in preventing blood loss. There are already rules for Platelet Factories and the Blood Circuit Control System, both of which are pretty solid ideas. There are also rules for oxygenated florocarbons (or whatever they are called in SR4), which are like the enhanced oxygen carrying blood replacements mentioned above, tho they give no bonus to damage resistance per RAW.

The concept behind the BCCS is pretty sound. You could get a lot of milage by cutting off tissues that don't need blood emergently. For example, if you had to cut off blood flow to the gut, spleen or liver for 5-10 minutes to finish murdering your enemies in the face, that wouldn't kill you. And that would only take a few valves at Celiac, SMA and IMA. Kidneys need a little more perfusion or they can be injured, but a few minutes wouldn't seriously hurt them either. Thats two more valves for each renal artery, for five total. The point being, you don't need to digest food or purify metabolic waste products to survive on very short time scales. If your choices are death vs. acute kidney failure (which can be fixed later) its better to keep the blood circulating from your lungs to your brain via the heart. Thats all you really need (again on very short time scales).

You could also cut off blood flow to the limbs if need be. The problem here is that you force the muscles into aerobic respiration. If continued long enough this would cause fatigue and burning as lactic acid builds up. This could be fixed with a system that balances pH and/or scavenges lactic acid and converts it back to useful fuel. A genetic augmentation would be great here.

As far as armoring vasculature goes, I don't think you would have to go to such lengths. Really, platelet factories would be the best thing for small peripheral vessels. In major arteries though you could have nanites implant a mesh of sensor fibers into the vessel wall that also double as contractile elements. If the system detects a disruption of the net architecture, fibers surrounding the damaged segments contract pulling the walls of the artery closed. A "Reticular Hemostasis System" if you will. This might cut off blood supply, but if you have good collateral circulation (like strategic by-passes and shunts) that shouldn't be a big deal.

Another novel concept might be to implant a drug reservoir or gland that stores an hyper-osmotic fluid (like a concentrated albumin solution or Hetastarch) and releases it into the blood stream in response to blood loss. If you could quickly increase the osmolarity of the blood you could draw fluid out of the tissues into the circulation to compensate for lost volume. Of course if your osmotic fluid also leaks out through a bullet hole, it won't help you much.

Anyway, I'm not sure if any of that is useful, but there it is.

Method, great you're chiming in with some actual expertise.

It seems to me the biggest problem with platelet factories, BCCS and your Reticular Hemostasis System is that it only stops blood loss, which could well mean that you're stuck without circulation. A hit to the heart, aorta or other major blood vessel would still incapacitate you. The addition of a backup heart and secondary circulation system for major blood vessels would fix that.

Absolutely. A backup pump, or a seires of micro pumps would be well worth it. There is a similar system called an intraaortic ballon pump IRL but with SR technology you could do something far more elegant and sustainable. The easiest way I can think of would be a bypass graft from the pulmonary vein in each lung hila up through the lung apex to the carotids with a micro pump for each. Since your brain has a nifty little structure called the Circle of Willis this would in effect give you a triple redundant system.

Hmm, so the Oxyrush nanites are distributed throughout your blood stream and carries enough oxygen to keep your body running for hours. Combine that with a BCCS and you could shut down all circulation and still keep everything running. Getting hit would at worst mean that you could lose the blood to the nearest valves - and with no circulation, you wouldn't even lose that much, much of it would just stay in the vessels.

That's a good catch Udoshi. Even if it isn't per the rules, from a medical point of view, oxyrush plus BCCS would seem to make you practically unstoppable except for a CNS hit.

I don't have any special knowledge in medicine so please ignore this if what I say is plainly wrong.

I don't think completely stopping all blood circulation is a good idea even with oxyrush nanites. The nanites would provide the oxygen but what about all the other stuff, that is transported with the blood? How long can a cell keep working, when there is no uptake of carbon dioxide produced in the cell, or do the nanites take care of that as well? And what about hormones like adrenaline? These are distributed via blood circuit as well, aren't they?

-CJ

Yeah, you could well be right. I have no idea how long it takes for it to become a problem, and high levels of carbonic acid could become a major problem I think. There's also lactic acid, especially since you can't get blood glucose from the liver, and probably a ton of other waste products. I don't know how similar the situation is, but something like crushed limb syndrome where people have blood flow cut off from the limb, once the object is lifted off and blood flow resumes, the toxins from the limb kills the patient as it enters the main system.

I don't think it will be a serious issue for many minutes though, and if you can buy yourself 5 or even 10 minutes of near invulnerability, that would be significant.

But considering the problems you point out, the best option would be to only let the BCCS shut down circulation when and where you're bleeding, yeah. It is still a major benefit from oxyrush that shut down areas will have plenty of oxygen but no circulation, rather than just no circulation period.

I like the idea of using Oxyrush to just shut down the whole system in an emergency. You could also use Universal Nantidotes in tandem with that to mop up any toxic waste and possibly a Carcerand plus system to deliver glucose and various drugs.

I wonder if you could use that to deliver some sort of sealant to the site of wounds automatically?

Harjel, technological Regeneration . . ok, not quite, but more or less instant scar tissue . .

Aren't Oxygenated Fluorocarbons a blood substitute? Couldn't you get an Internal Air Tank full that and have it rigged to release at a signal from your biomonitor?

hi hi

I can just see it now:

Victim: "You heartless monster!"
Cyber-monster: *kablam* "I take offense to that... I'm not heartless, I have two!"
Victim: *gurgle*

An air tank only puts air in your lungs. You need working lungs to oxygenate the blood, a working heart to circulate it, and sufficient blood pressure and intact blood vessels to get it working.

Injecting oxygenated fluids into the blood stream can take of lung damage and low blood pressure

The oxyrush nanites should take care of the CO₂ buildup, but the lack of glucose going to your cells could be a real issue. I'm unsure of how big of a reserve a cell keeps, or how long it can go without before it shuts down and dies. I would think it could be quite a while actually though. You can cut plant cells off a plant and watch them still alive under a microscope for a while. Sperm cells also zip around for a fair while on slides, but they are kind of designed to operate on their own.

Ah, but don't need multiple circulatory systems in your body. That's redundant and you also mentioned the space issue. What you need is a fast way to create a bypass when a blood vessel is damaged. And I think nanites are they way to go to achieve this.
Imagine a nanite system that's able to "build" blood vessels "on demand". We already know, that nanites can assist in forming nerve tissue and synapses (neocorticals), so why not other types of tissue?

-CJ

It doesn't even have to blood vessel tissue as such. Just the ability to tunnel through tissue, around the wound, connect to the artery, and inflate a blood-tight tunnel that the blood can flow through, anything allowing that would do. Maybe it needs valves too, I don't know how long a stretch of blood tunnel you can have before lack of valves preventing run back become a problem - it probably depends on the rigidity of the nanobloodvessel.

So, I asked my Molecular Biology teacher about how long a human cell could survive without glucose (or other food and such) and she said about an hour or so. So, if a system simply shuts down your blood circulation entirely, you've got about an hour before your cells die from lack of food. Muscle cells might not last nearly as long if you're active. Perhaps 15-30 minutes. Still, that's plenty of time to get you through a firefight where you can't die of blood loss, get out of the area, and call an ambulance or maybe even drive yourself to a hospital.

Since all damage can be healed by sleeping it off long enough, I think we can assume that no normal attacks are CNS hits, so you could make yourself temporarily immortal with this setup.

Perhaps the reason it isn't in the game isn't that it wouldn't be effective enough, but that it would be too effective.

Or because they just didn't think of it.

Sci-fi is always hard; accounting for the possibilities of yet-to-discover technologies.

I suppose halting blood circulation would also suspend several toxins from functioning, though most combat toxins would be neurotoxins anyway.

Again though, wouldn't a lack of circulation also prevent those neurotoxins from working particularly well? Okay, you get hit with Neurotoxin A. It kills nerve function in your arm. How would it travel through your body to hurt the rest of your nervous system?

For all the benefits of such a system (or series of systems working together), wouldn't it be better (or at least easier) to create a spell that does the same? You could even have it powered with mana based handwavium.

As I understand it nerve agents like Sarin are absorbed through the skin and target nerve cells. Shutting down blood flow, having artificial heart(s) and oxyrush nanites could certainly delay the fatal effects but you would still be badly fucked up. Uncontrollable spasms, vomiting, defecating and urinating might be the least of your problems.

edit

It might well be wise to invest in a genetic immunity to acetylcholinesterase inhibitors. Pufferfish do very well out of resistance to TTX...

An auto-injector coupled with a biomonitor, injecting just the right amount of a liquidized hydrogensulfide compund could put you in suspended animation and stop the blood flow dead in its tracks.

Suspended animation is probably a bad idea in combat. The idea is to remain functional. But that is an interesting lecture.

Well, it's hard to remain functional if you want to stop the blood flow without suspended animation =)

Isn't there already some kind of ware that does that? Basically if you go into overflow it slows the rate you take damage by alot?

Metabolic arrester.

Yeah, but suspended animation would keep you in a stable condition almost indefinitely. And they could even operate on your, without the need for further anaesthetics.

Reading back through previous posts: Your cells can in deed continue to function for quite awhile without glucose or toxin clearance so long as they have oxygen (or some other molecule that functions as an electron acceptor). The real issue is that your blood becomes acidic as CO2 and lactic acid build up, which will eventually alter enzyme kinetics, membrane stability and all kinds of other stuff.

So you have to keep in mind the time frame. If you are depending on these systems to keep you alive for hours, your probably toast. Thats when you want a metabolic arrestor or a system like D2F proposed. Trauma-ware should be designed to keep you upright and functional long enough to escape from combat and reach emergent medical attention. To be specific, the goal is just to divert blood volume away from the body to maintain blood pressure between the lungs and the brain. We're talking minutes to half an hour at the max. After that these systems would start to cause organ failure.

Edit: Interesting. Mark Roth (in the linked video above) is from UW where I went to medical school...

CO2 shouldn't be a problem. The nanites should be able to replace any O2 that they've lost with the CO2 just like our own blood does. No glucose means cell death in about an hour or less, and you're going to start running into problems before then. Active cells like muscle cells will run into problems even faster. If I'm remembering my biochemistry (not my favorite subject) right, lactic acid is only a problem if you have anaerobic respiration, which you shouldn't have to worry about with oxyrush nanites.

I do agree though, without some means of a glucose supply though, you've got anywhere from 15 minutes to an hour or so, depending on what you're doing during that time. I do however imagine that the carcerand nanites could be used to carry large stores of glucose, so that you might be able to operate for several hours with your circulatory system entirely shut down. I suppose max oxyrush air supply is 2.5 hours, and you could likely match that with glucose stores in carcerand nanites. At that point, the next issue is 'waste' produced by cells. Few options here. One is that the carcerand nanites might be able to pick up and store this waste after they release the glucose. Another is that things to neutralize them could be carried and released as needed to keep the cells operating properly.

You are correct; your muscles will pump out lactic acid only if they are using anaerobic respiration. My comment was based more on the idea of shunting blood away from the limbs than the use of oxyrush.

As far as oxyrush goes: I would note that per RAW they give no bonus to damage resistance or overflow. We'd have to come up with an alternate HR mechanic.

And as for carcerands transporting glucose: I think it would also be feasible to modify muscle cells to store glycogen and/or perform gluconeogenesis.

The fluff of Universal Nantidote nanites is perfect for that. They could scrub out the toxins while the Carcerands and Oxyrush supply the essentials.

In extremis, trapped under the rubble of an earthquake, you could have Carcerands loaded with Slab to greatly extend survival time.

I still prefer the unlimited survival time, though =)

No doubt.

With oxyrush, wouldn't you just need to seal off the brain? Who cares about lungs when your blood itself contains enough oxygen to last for hours?

Good point. You are right, but then that seems too easy...

Hehe. About two posts in I got the image of someone with oxyrush nanites getting a hole the size of a bowling ball blown in their chest and then just tying a tourniquet around their neck.

The glucose issue would come up pretty fast though. It's all about making that ATP.