"Survival" here being, of course, not a black-and-white thing:
> Outcome and Follow-Up
> On day 59, the boy was discharged to inpatient neurorehabilitation. At 6-month follow-up, he was giving short commands, standing without support, riding a tricycle, eating soft foods, and relearning simple tasks. Peripheral neuromuscular weakness continued to improve.
I'd be curious to read about 1, 2, 5, 10, 20 year follow-up.
Party pooper warning.
I'm afraid I don't have rose tinted glasses, due to personal experience with a family member with TBI (accident at age 16, 3 weeks in a coma). The aftereffects are profoundly destabilizing to his environment. I sometimes have quite a dark view of people's need to be a rescuer and celebrate the "alive!", when they don't have to deal with the next 40-60 years of living...
That is incredible. 2.5 hours underwater, 1.5 hours of CPR. They were instructed not to start rewarming him until he could be given more comprehensive treatment at a hospital. They list 'death' as a differential diagnosis...
He didn't come out unscathed though. They describe his progress:
> At 6-month follow-up, he was giving short commands, standing without support, riding a tricycle, eating soft foods, and relearning simple tasks. Peripheral neuromuscular weakness continued to improve.
which is quite limited for an 8-year old, but remarkable considering the circumstances.
The timeline lists "Sled tracks seen to broken bond ice, EMS called" at 16:44. He was pulled from the water at 18:57. The article text further clarifies:
Parents discovered sled tracks from home onto broken pond ice through which he fell.
He left the house at 16:00, which is why they give the range of 147 to 177 minutes.
It seems below about ~80F you lose consciousness. This kid was nearly half that. Moreover, there have been other similar cases: https://pubmed.ncbi.nlm.nih.gov/32482520/
I remember that cryogenesis was deemed viable in the 80ies but essentially surface area is your enemy. Anything larger than a cat can’t be resurrected. It’s pretty bizarre really, they froze mice and microwaved them back to life.
Weird! I wonder if there is some exponential complexity going on. More neural pathways leaving more stuff that can potentially break from an uneven freeze/thaw? Or is it literally that the freezing and thawing can't happen evenly when you're too big? A brief transistional period with unfrozen outsides and frozen solid insides is probably not great for you.
Well written article. Life is a miracle. We are trying to understand it & there is more to learn everyday. I remember a couple of years ago, a 50yr patient (someone I know) was saved from a severe heart attack using induced hypothermia and recovering them slowly.
Unlikely. The issue is cold and the speed of the cold. Children have a higher surface-to-mass ratio along with less subcutaneous fat which allows them to cool quickly. The article quotes the breakpoint:
If water temperature is >6 °C (43 °F), survival is unlikely for submersion >30 minutes.
And even still, it isn't like the child came out unscathed.
That passage bears quoting at length, it's where I really teared up:
> At initiation of ECMO, the boy's rhythm was asystole. The boy was rewarmed with an ECMO heat exchanger-patient gradient ≤10 °C. [...] As the patient's temperature approached 22 °C (72 °F), low-frequency and low-amplitude sinusoidal electrical deflections were noted on his electrocardiogram. As the patient continued to rewarm, these phasic electrical deflections slowly increased in frequency and amplitude. At approximately 28 °C (82 °F), sinusoidal deflections organized into more classic cardiac electrical activity reminiscent of sinus bradycardia with a wide complex. Amiodarone, calcium gluconate, magnesium sulfate, bolus epinephrine, and epinephrine and norepinephrine infusions were administered. After further rewarming, sinus bradycardia developed and ultimately progressed to normal sinus rhythm...
"Survival" here being, of course, not a black-and-white thing:
I'd be curious to read about 1, 2, 5, 10, 20 year follow-up.
Party pooper warning.
I'm afraid I don't have rose tinted glasses, due to personal experience with a family member with TBI (accident at age 16, 3 weeks in a coma). The aftereffects are profoundly destabilizing to his environment. I sometimes have quite a dark view of people's need to be a rescuer and celebrate the "alive!", when they don't have to deal with the next 40-60 years of living...
That is incredible. 2.5 hours underwater, 1.5 hours of CPR. They were instructed not to start rewarming him until he could be given more comprehensive treatment at a hospital. They list 'death' as a differential diagnosis...
He didn't come out unscathed though. They describe his progress:
> At 6-month follow-up, he was giving short commands, standing without support, riding a tricycle, eating soft foods, and relearning simple tasks. Peripheral neuromuscular weakness continued to improve.
which is quite limited for an 8-year old, but remarkable considering the circumstances.
There was some medical terminology that I didn't understand. The NotebookLLM podcast version is disturbingly good: https://notebooklm.google.com/notebook/21c5eddb-ada4-4726-85...
I am sceptical about the 147 minutes, the child could have still clinging onto the ice and just drowned a minute before the parents reached the pond.
The timeline lists "Sled tracks seen to broken bond ice, EMS called" at 16:44. He was pulled from the water at 18:57. The article text further clarifies:
Parents discovered sled tracks from home onto broken pond ice through which he fell.
He left the house at 16:00, which is why they give the range of 147 to 177 minutes.
It seems below about ~80F you lose consciousness. This kid was nearly half that. Moreover, there have been other similar cases: https://pubmed.ncbi.nlm.nih.gov/32482520/
They’re not dead until they’re warm and dead.
Reminds me of the extended description of what it might be like to drown in an ice lake in the book Stella Maris — it wouldn't be quick.
I remember that cryogenesis was deemed viable in the 80ies but essentially surface area is your enemy. Anything larger than a cat can’t be resurrected. It’s pretty bizarre really, they froze mice and microwaved them back to life.
Weird! I wonder if there is some exponential complexity going on. More neural pathways leaving more stuff that can potentially break from an uneven freeze/thaw? Or is it literally that the freezing and thawing can't happen evenly when you're too big? A brief transistional period with unfrozen outsides and frozen solid insides is probably not great for you.
I would assume it is purely because of the mass.
Well written article. Life is a miracle. We are trying to understand it & there is more to learn everyday. I remember a couple of years ago, a 50yr patient (someone I know) was saved from a severe heart attack using induced hypothermia and recovering them slowly.
Incredible. I wonder if they can make progress on survivability of regular drowning.
Unlikely. The issue is cold and the speed of the cold. Children have a higher surface-to-mass ratio along with less subcutaneous fat which allows them to cool quickly. The article quotes the breakpoint:
And even still, it isn't like the child came out unscathed.I was rewatching The Abyss for the first time since 1989 and wondered just what is the process for reviving an asystole heart[^1].
[^1]: It was only relatively recently that I learned you can't shock an asystole heart. e.g. https://medicalsciences.stackexchange.com/questions/5874/can...
CPR and a boatload of epinephrine, it seems.
That passage bears quoting at length, it's where I really teared up:
> At initiation of ECMO, the boy's rhythm was asystole. The boy was rewarmed with an ECMO heat exchanger-patient gradient ≤10 °C. [...] As the patient's temperature approached 22 °C (72 °F), low-frequency and low-amplitude sinusoidal electrical deflections were noted on his electrocardiogram. As the patient continued to rewarm, these phasic electrical deflections slowly increased in frequency and amplitude. At approximately 28 °C (82 °F), sinusoidal deflections organized into more classic cardiac electrical activity reminiscent of sinus bradycardia with a wide complex. Amiodarone, calcium gluconate, magnesium sulfate, bolus epinephrine, and epinephrine and norepinephrine infusions were administered. After further rewarming, sinus bradycardia developed and ultimately progressed to normal sinus rhythm...
Wim hof has a similar childhood story (maybe not quite as extreme)...
Wim hof has a lot of stories, hard to tell which ones are true or not unfortunately.