British woman revived after six-hour cardiac arrest

by elmaron 12/6/2019, 11:12 AMwith 165 comments

by jobigoudon 12/6/2019, 11:25 AM

> In a race against time, doctors treating Mrs Schoeman turned to a specialised machine capable of removing blood, infusing it with oxygen and reintroducing it to the patient.

> Once her body temperature had reached 30C, they used a defibrillator to jump-start her heart some six hours after emergency services were contacted.

> Mrs Schoeman was released from hospital 12 days later, with only some lingering issues with the mobility and sensitivity of her hands due to the hypothermia.

> How long her heart stopped for is not clear - she may still have had some circulation, although not detectable.

by phigcchon 12/6/2019, 3:00 PM

There's a nice research article from 2016 by doctors in northern Norway about resuscitation of frozen patients:

“Nobody is dead until warm and dead”: Prolonged resuscitation is warranted in arrested hypothermic victims also in remote areas – A retrospective study from northern Norway

J. Hilmo, T. Naesheim, M. Gilbert https://www.sciencedirect.com/science/article/pii/S030095721... (open access, CC licence)

Same hospital and team that treated Anna BĂĄgenholm (mentioned in other comments, https://en.wikipedia.org/wiki/Anna_B%C3%A5genholm), and I guess that case is part of the study.

by orobinsonon 12/6/2019, 12:50 PM

It’s amazing how this phenomenon has been adapted into medical technology. When my son was born he wasn’t breathing properly and his blood oxygen levels dropped to critical levels. He was rushed to hospital and the first thing they did was cool him to 34c to reduce the risk of brain damage. He made a full recovery. I dread to think what would have happened without the cooling.

by Teandwon 12/6/2019, 2:26 PM

Some notes:

- The headline is clickbait/false really. The six-hour cardiac arrest is pretty much made up/guessed. In fact, they don't know how long she was in cardiac arrest. The article actually goes on to state "how long her heart stopped for is not clear", so it's a bit odd to say she had a six-hour cardiac arrest.

- The six hours timeframe actually refers to the fact that a defibrillator was used 6 hours after the emergency services were called.

- It mentions that doctors are stating it's the longest cardiac arrest ever recorded in Spain. This is a very odd thing for a professional doctor to do, when they have no evidence to back that up. As a doctor, you can't just guess she was in cardiac arrest for 6 hours and record it down as being what happend. That's misleading information.

by stuartbmanon 12/6/2019, 11:30 AM

ECMO is an amazing technology that's often used in futile situations. I don't know who the ideal candidate is for it, but a young, fit, hypothermic cardiac arrest victim is pretty high up on the list

by afthonoson 12/6/2019, 11:21 AM

I read somewhere "you are not dead until you're warm and dead". Data point in favor.

by rkagereron 12/6/2019, 5:07 PM

When I began volunteer firefighting, curiosity led me to research the longest known CPR survival cases. Here are a few more rare and incredible tales:

https://web.archive.org/web/20191206164443/http://www.leapbe...

If you've never taken a CPR course, sign up for one! It could save a life one day.

by drbyteson 12/6/2019, 1:16 PM

Reminds me about a quote I heard, don't remember where, about Napoleons main medic.

Apparently he noticed that equally injured soldiers would die at different times based upon how close they were to the camp fire with those closest expiring way before those laid out the farthest from the fire.

Could be a bs story, I never actually looked into it.

by MarkMcon 12/6/2019, 1:38 PM

Does this suggest that humans can be put into 'hibernation' to extend their lifespan? (Edit: I mean would be possible in future if we had a better understanding of the process?)

If I was rich enough I'd host a competition to extend the life of rats: Each year, whoever could demonstrate a technique to reliably extend the lifespan of a rat by at least 10% over the previous year's record would win a million dollars. I expect that the wining entry would involve putting the rats into controlled hypothermia.

Over the years the maximum lifespan will grow and we may even find that we can put rats into hibernation indefinitely. It would then be a question of whether we can apply the same techniques to humans.

by jacquesmon 12/6/2019, 11:37 AM

Related:

https://www.iflscience.com/health-and-medicine/child-survive...

There are a few such known examples, also some that looked good for a while but ended with a tragedy as much as a day later. I can see some parallels with the drowning case due to the hypothermia, the onset of which must have been relatively fast.

by ghufran_syedon 12/6/2019, 6:54 PM

On the other hand, cooling people after return of spontaneous circulation (ROSC) does NOT seem to help in any clinically significant way:

https://www.ncbi.nlm.nih.gov/pubmed/31778636

by pvaldeson 12/6/2019, 4:47 PM

I'm very proud of Spanish healthcare at this moment. We have a terrific team here.

Another recent example of one of our rock star doctors involving the successful reattachment of a severed hand without blood flow for 10 hours.

https://www.thinkspain.com/news-spain/30483/super-surgeon-dr...

by m463on 12/6/2019, 9:31 PM

A fascinating book to read is "King of Hearts: The True Story of the Maverick Who Pioneered Open Heart Surgery" by G. Wayne Miller.

Early open heart surgery was pioneered with TWO patients whose circulatory systems were connected together so that patient two could could breathe and pump blood for patient one while the heart was stopped.

Amazing (in a sort of blank-faced-blink-blink sort of way)

by backspace_on 12/6/2019, 2:59 PM

This article is all flash with little substance. They used a "specialized machine" and never once named it. As others have mentioned this sounds exactly like ecmo. Its obvious to me that they are really simplifying the situation for their readers.

by bhickeyon 12/6/2019, 11:50 AM

Outside has a good narrative of hypothermia. https://www.outsideonline.com/2152131/freezing-death

by Tepixon 12/6/2019, 12:02 PM

So, I still don't know if you are irreversibly dead if your brain stops all activity.

I.e. is the state of your brain preserved just by the connections of the neurons? Or is the "RAM" also critical?

by gregdon 12/6/2019, 4:08 PM

As someone who was once an NREMT-B in the US, we were taught that someone isn't dead, until they're cold dead. I haven't read the article yet, but I assume they kept her warm.

by mrandishon 12/6/2019, 2:21 PM

Many Tier 1 regional trauma centers now have the equipment to induce hypothermia on hand. Hopefully, this will become standard gear in all trauma departments

by isostaticon 12/6/2019, 1:28 PM

Good job it wasn't in america, she'd have woken up, seen the bill, and had another heart attack!

by rolltiideon 12/6/2019, 2:47 PM

I occasionally run into people that want to deter even thinking about the idea of life saving options because of the universe/god’s plan

I met the most spiritual woman who was also in a crusade against Abrahamic religions say that

What a completely unfalsifiable version of logic when the “plan” could just as easily be the treatment

I got through the impasse by saying it just gives people choices even if the choice is already written in stone

Schrodinger’s free will

by BigChiefSmokemon 12/6/2019, 12:36 PM

How did her brain survive with seemingly no oxygen being replenished thru circulation?