This is how a Norwegian woman survived the lowest body temperature ever recorded She froze to death and lived to tell the tale. 一位挪威女性在歷史最低體溫中存活,她被凍死又復生,她的故事是什麼呢?

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This is how a Norwegian woman survived the lowest body temperature ever recorded

She froze to death and lived to tell the tale.

一位挪威女性在歷史最低體溫中存活,她被凍死又復生,她的故事是什麼呢?

 

In May 1999, 29-year-old radiologist Anna Bågenholm and two other young doctors set out for a day of skiing in the Kjolen Mountains of Norway.

All experienced skiers, they headed off track to enjoy the fresh powder, but Bågenholm took a fall and slid downhill, landing head-first through the ice of a frozen stream. 

 

1999 年五月,二十九歲的放射科醫生Anna Bågenholm以及其他兩位年輕醫生出發前往挪威的基阿連山脈Kjolen Mountains)滑雪。所有有經驗的滑雪者會避開人多的地方享受新鮮的白雪,但是Bågenholm女士跌倒,並且滑落斜坡,頭先著地,撞上結冰的河流。

 

Her friends quickly grabbed hold of her skis and tried to pull her out, but the ice was too thick and she was jammed between rocks. They called for help, but in the meantime, Bågenholm was stuck upside down, in heavy gear, and being pulled in by icy cold water – pretty much a worst-case scenario. 

Thankfully, she managed to find a pocket of air, and struggled to stay conscious waiting for help to arrive, but after 40 minutes, she stopped moving. By the time the rescue team arrived, she had been under the ice for 80 minutes, and was frozen solid.

 

她的朋友迅速地抓住她的雪撬,試圖把她拉起來,但是冰太厚,而她被卡在石頭間。他們聯絡救援人員,但是於此同時,Bågenholm正頭下腳上的卡在那裡,身上穿著厚重的衣物裝備,被冰冷的河水拉扯,可以說是最糟糕的狀況。

 

幸好,她找到一處可以吸到空氣的縫隙,並且努力維持意識,等待救援,但是四十分鐘後,她停止了活動。當救援隊到達,她已經在冰下待超過八十分鐘了,並且冰冷僵硬。

 

 

By the time she reached the operating room at the hospital, it had been more than 2.5 hours since she first fell in the ice, and her temperature was still an unprecedented 13.7 degrees Celsius (56.7 Fahrenheit). 

 

“On the ECG [electrocardiogram], which the doctor on the helicopter has connected her to, there is a completely flat line. Like you could have drawn it with a ruler. No signs of life whatsoever.”told CNN a decade later. 

 

當她被送到醫院的手術室時,從她落冰開始已經過了兩個小時半,而她的體溫來到前所未有的攝氏13.7 度(華氏56.7 度)。

 

在十年後,CNN 被告知:「在直升機上,醫生將心電圖(ECGelectrocardiogram)和她連接,顯示結果是一條完全水平的線,就像用尺畫出來的一樣。完全沒有生命跡象。」

 

But he made an important decision. “We will not declare her dead until she is warm and dead,” said Gilbert.

Gilbert’s hope was that Bågenholm was so cold that her brain would have begun to slow down before she died, protecting it from damage.

At our bodies’ preferred temperature of 37.5 degrees Celsius (99.5 Fahrenheit), our brains can only go for around 20 minuteswithout oxygen before irreversible damage sets in. But as we cool down, the body’s metabolism also slows way down in order to keep us alive, which means the brain can get by with far less oxygen.

 

Gilbert 做了一個重要的決定,他說:「我們不會宣告她死亡,直到她的身體溫暖但是死亡。」

 

Gilbert 希望Bågenholm女士的大腦可以因為低溫而自動減緩活動,在她死去前自我保護,防止有傷害產生。

 

身體喜愛的溫度是攝氏37.5 度(華氏99.5 度),我們的大腦只能在缺氧狀態下支撐大約20 分鐘,在不可逆的傷害發生前。但是當我們冷卻,我們身體的代謝也會慢下來,維持我們的生命,也就是說大腦可以再更缺氧的情況下撐過去。

 

His team hooked Bågenholm up to a heart-lung machine, and they pumped her blood out of her body to warm up before circulating it through her again – very gradually, over several hours, her temperature began to rise.

The heart monitor blipped a few times, but continued to flatline. The team waited. 

At around 4pm the next day, almost a day after Bågenholm had fallen into the river, her heart restarted, and began pumping the blood on its own again.

Gradually the rest of her body began to heal, too. After 12 days, she opened her eyes, but it took more than a year for her to be able to move and walk again due to nerve damage.

 

他的團隊將Bågenholm女士與人工心肺機(heart-lung machine)連結,他們將她的血液抽出並加溫,在血液重回她的身體循環前。最終,經過幾小時後,她的體溫開始上升。心臟監測儀(heart monitor)有幾次反應,但是之後還是顯示水平。整個團隊等待著。在隔天下午四點左右,經過Bågenholm 掉下河中幾乎一天後,她的心跳又開始跳動了,開始自己泵送血液。最終身體其他的部分也開始痊癒。經過十二天後,她張開了她的眼睛,但是她花了超過一年才能再開始走路、移動,因為神經的損害。

 

She’s now fully recovered, and works at the same hospital that saved her life. 

Her case didn’t only make the record books, and a study in The Lancet journal – it also changed the way doctors approached hypothermia deaths.

“In a victim of very deep accidental hypothermia, nine hours of resuscitation and stabilisation led to good physical and mental recovery. This potential outcome should be borne in mind for all such victims,” concluded The Lancet study.

Before 1999, no patient had survived being frozen to death at the University Hospital of North Norway. But between 1999 and 2013, nine out of 24 patients survived hypothermic cardiac arrest, a 2014 study led by Gilbert found. 

 

她現在已完全康復,並且在拯救她性命的醫院工作。她的案例不只記錄在紀錄簿中,也記錄在《刺胳針》The Lancet,為世界上最悠久及最受重視的同行評審性質之醫學期刊之一)的一篇研究中。這也改變了醫生對低溫死亡的判定方法。

 

《刺胳針》的研究總結:「一個嚴重意外低溫死亡的受害者,經歷九小時的人工心肺復蘇以及穩定,可達成良好的生理以及心理復原。像這樣的例子的復原潛力必須要被銘記於心。」

 

在1999 年以前,沒有低溫死亡的患者在北挪威大學醫院(University Hospital of North Norway)存活。但是在1999 年到2013 年間,有在二十四位病人中有九位從低溫心臟驟停中存活,這被記錄在一份2014 年由Gilbert 主導的研究中。

 

Doctors at the University of Pittsburgh Medical Centre hospitalare now actually inducinghypothermia in critical patients, to prolong the windowin which they can stop their bleeding and save their lives. 

“We think of death as being a moment in time,” physiologist Kevin Fong told NPR back in 2014, “but actually, it is a process.”

“It’s the three important things about emergency medicine, which is never give up, never give up, never give up,” Torvind Næsheim, one of the doctors who was skiing with Bågenholm that day told CNN. “Because there’s always hope.

 

匹茲堡大學醫學中心University of Pittsburgh Medical Centre hospital)的醫生現在將低溫死亡列入危重病人中,讓這類病人能有更好的機會止血並被救活。

 

生理學家Kevin Fong2014 年告訴NPR( National Public Radio,全公共廣播電台):「我們一開始有想過沒希望了,但是這只是過程。」

 

Bågenholm 女士一同滑雪的醫生Torvind Næsheim告訴CNN:「緊急治療最重要三件事是永不放棄、永不放棄、永不放棄。因為永遠有希望。」

 

 

來源:sciencealert

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