It has become a hot topic after it was reported that an 18-year-old man, who had suffered cardiac arrest for about 90 minutes after getting lost during a mountain marathon held in northern Italy, was dramatically revived.
According to the Italian online media PenPage, pianist and music school student Jiri Marzi was involved in the Lake Como Marathon Trail held in the Lake Como area on September 27th when he went off the course and was in distress. Even though the course was shortened on the day of the competition due to bad weather, he did not arrive at the final checkpoint and a missing person alert was issued.
Isolated in the cold for over 5 hours, body temperature was 21℃ when discovered.
Jiri left at 8:30 a.m. and was last seen around 12:30 a.m. before disappearing. The competition immediately requested rescue, and the mountain rescue team began searching at 2:43 p.m.
The time he was discovered was 6:10 PM, and the location was a mountain ridge 2,000 meters above sea level. When rescuers arrived, he was without a heartbeat and his body temperature had dropped to 21 degrees Celsius. He was unconscious at the time of rescue. In a later interview, he recalled, “My fingers were frozen and I couldn’t pick up my phone or open the energy bar package.”
Hypothermia caused his heart to stop, but it also saved his life.
Dr. Fernando Luca Lorini, head of emergency medicine at a local hospital, explained, “When discovered, the patient was literally dead. Both heart and lung functions had stopped, and body temperature had dropped to 21°C.” He continued, “The quick identification that the cause of the cardiac arrest was not trauma but hypothermia, which resulted in an extremely slow metabolism, saved his life.”
Medically, when body temperature drops sharply, metabolic activity decreases significantly and the functions of major organs such as the brain and heart temporarily slow down. In fact, the medical staff assessed that his body’s metabolic rate had decreased by nearly 80%. This condition delayed organ damage, greatly increasing the time available for treatment, and was critical to the effectiveness of the prompt treatment that followed.
ECMO activated in 17 minutes… Replaces organ function and aids recovery
Jiri arrived at the hospital around 7:01 p.m., and started ECMO (extracorporeal membrane oxygenation) treatment 17 minutes after arrival. This is a treatment that prevents organ damage and gives time for recovery in cases of cardiac arrest by having a machine take over the functions of the heart and lungs, circulating blood and supplying oxygen.
Dr. Lorini said, “The patient was in cardiac arrest for more than an hour, but thanks to hypothermia, organ damage was minimized.” This case is considered a rare case of recovery from cardiac arrest due to hypothermia without organ damage, and will be officially announced at a medical conference held at the Pope John XXIII Hospital in Bergamo on January 10th next year.
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Q1. How was it possible to resuscitate after 90 minutes of cardiac arrest when body temperature dropped to 21℃?
Hypothermia significantly reduces metabolic activity, slowing the rate at which brain and organ damage occurs. In the case of Jiri Marji, the metabolic rate decreased by about 80%, allowing ‘time’ for treatment, and ECMO, which was implemented quickly, took over the function of the organs and made recovery possible.
Q2. What role does ECMO treatment play in cardiac arrest patients?
ECMO (extracorporeal membrane oxygenation) uses a machine to perform the functions of the heart and lungs, circulating blood and supplying oxygen. It is an essential treatment for maintaining organ function in cardiac arrest, giving the heart time to recover.
Q3. Why is this case considered a ‘rare case’ in the medical community?
In general, if cardiac arrest lasts 5 to 10 minutes, the risk of brain damage increases. However, despite being in asystole for about 90 minutes, Jiri recovered without neurological damage. This is a very rare case in which several conditions, including extreme low body temperature, immediate rescue, and ECMO administration, were met exactly.
