March 23rd, 2012
11:55 AM ET
Could everyday folks get the kind of intensive resuscitation efforts that Fabrice Muamba, a soccer player whose heart stopped beating for 78 minutes?
The 23-year-old pro-athlete’s cardiac arrest and his subsequent revival during a British soccer match generated international headlines this week. Muamba was described as being “in effect dead” by the team doctor.
Doctors applied life-saving measures such as chest compressions and 15 defibrillator shocks during the 48 minutes to get Muamba to the hospital and an additional 30 minutes at the hospital. Muamba remains at a hospital in London and has been talking.
“It's rare that somebody after 78 minutes can be revived,” said Dr. Susmita Parahsar, an assistant professor of medicine and cardiology at Emory University.
The ability to resuscitate him after more than an hour is “remarkable – this case is more exceptional than most,” said Dr. Benjamin Abella, the clinical research director in the Center for Resuscitation Science at the University of Pennsylvania. Neither doctor is involved in Muamba’s care.
From the stadium to the hospital, doctors in England tried for over an hour to resuscitate Muamba. He had a type of cardiac arrest where the heart showed lots of electrical activity but no muscular activity, according to the team's doctor.
An electrical system controls the heart and uses these electrical signals to contract the heart's walls. But without the pumping action of the heart, the blood can’t move and carry oxygen and nutrients throughout the body. When a person’s heart stops, medical workers compress the patient’s chest to manually pump the heart and keep blood flowing throughout the body. In Muamba’s case, CPR continued for well over an hour.
Would most people suffering cardiac arrest get the same level of first aid that was given to Muamba?
“No, they wouldn’t,” said Abella. “They would not necessarily have access to that care.”
Muamba’s circumstances were highly unusual since he collapsed publicly in the middle of the soccer game where there were doctors on sidelines who immediately came to his side.
“It helped that it happened in a public setting. At their home, the response would’ve been much slower,” Abella said.
Life-saving techniques, such as CPR and cooling a patient's body called therapeutic hypothermia are blurring the line between life and death.
“What used to be an on-or-off thing, it’s becoming a gray area,” he said. “You can be mostly dead. You can be restored back to health and life, so that’s becoming hard to define.”
Typically, doctors view about 20 to 30 minutes as the limits for survival, although some resuscitation efforts have continued for over an hour, Abella said. Muamba’s survival is a testament that the first-responders on the soccer field “did a fantastic job of CPR and defibrillation.”
There is no defined length of time that doctors are supposed to continue CPR.
“As a physician, the hardest thing about CPR is to know when to stop,” said Parashar. “You want to do your best for the person. Every person, every case is different. Sometimes, for a person who’s young, you do your best and go on for some more time. There is no cut off.”
All organs in the body depend on blood flow so when the heart stops pumping properly, this can cut off blood flow and damage any organ in the body such as the brain, liver and kidneys. Some people after an incident like Muamba’s recover without any neurological damage. But they might have defibrillator burns and chest pains from the CPR.
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