page_title: Anna Bågenholm
section_title: Resuscitation and recovery
hierarchical_section_title: Anna Bågenholm / Resuscitation and recovery
caption_attribution_description: A Royal Norwegian Air Force Westland Sea King Mk.43 helicopter in the summer of 2004.
context_page_description: Anna Elisabeth Johansson Bågenholm is a Swedish radiologist from Vänersborg, who survived after a skiing accident in 1999 left her trapped under a layer of ice for 80 minutes in freezing water. During this time she became a victim of extreme hypothermia and her body temperature decreased to 13.7 °C, one of the lowest survived body temperatures ever recorded in a human with accidental hypothermia. Bågenholm was able to find an air pocket under the ice, but suffered circulatory arrest after 40 minutes in the water.
  After rescue, Bågenholm was transported by helicopter to the Tromsø University Hospital, where a team of more than a hundred doctors and nurses worked in shifts for nine hours to save her life. Bågenholm woke up ten days after the accident, paralyzed from the neck down and subsequently spent two months recovering in an intensive care unit. Although she has made an almost full recovery from the incident, late in 2009 she was still suffering from minor symptoms in hands and feet related to nerve injury. Bågenholm's case has been discussed in the leading British medical journal The Lancet, and in medical textbooks.
context_section_description: When Bågenholm was pulled out of the water, her pupils were dilated, her blood was not circulating, and she was not breathing. Falkenberg and Næsheim, both doctors, began giving her cardiopulmonary resuscitation (CPR). The rescue helicopter soon arrived and Bågenholm was brought to the Tromsø University Hospital in an hour. The helicopter emergency team continued to give her CPR during the flight, and she was ventilated with oxygen. She was also treated with a defibrillator, but to no effect.
  Bågenholm arrived at the hospital at 21:10. Her body temperature at the time was 13.7 °C (56.7 °F), the lowest survived body temperature ever recorded in a human with accidental hypothermia, until 8-year-old Stella Berndtsson survived a 13.0 °C (55.4 °F) body temperature in 2010. Dr. Mads Gilbert, an anesthesiologist and the chief of the hospital's emergency room, proceeded with the resuscitation attempt. He commented on Bågenholm's state: "She has completely dilated pupils. She is ashen, flaxen white. She's wet. She's ice cold when I touch her skin, and she looks absolutely dead." Gilbert had treated many cases of hypothermia before because of the cold climate in Norway, and knew how to treat Bågenholm. The electrocardiogram connected to her showed no signs of life, but Gilbert knew patients should be "warmed up before you declare them dead". He and his team hoped Bågenholm's brain had received enough oxygen from the CPR she was given after her rescue.
  Bågenholm was brought to the operating theatre, where a team of more than a hundred doctors and nurses worked in shifts for nine hours to save her life. At 21:40, she was connected to a cardiopulmonary bypass machine that warmed up her blood outside of her body before it was reinserted into her veins. Bågenholm's first heart beat was recorded at 22:15, and her body temperature had risen to 36.4 °C (97.5 °F) at 0:49. Bågenholm's lung function deteriorated at 02:20, and she spent the following 35 days connected to a ventilator.
  Bågenholm soon began to show signs of vitality, and woke up paralyzed from the neck down on 30 May. She feared she would spend the rest of her life on her back, and was angry with her colleagues for saving her. Bågenholm soon recovered from the paralysis, however, and later apologized to her friends; "I was very irritated when I realized they had saved me. I feared a meaningless life, without any dignity. Now I am very happy to be alive and want to apologize." Bågenholm's kidneys and digestive system were not working properly, so she had to recover in an intensive care unit for two more months. After spending 28 days in the Tromsø intensive care unit, she was flown to Sweden in an ambulance helicopter for the remainder of her recovery.
  Dr Petter Andreas Steen, professor at the National Hospital in Oslo, said it was "an extraordinary medical achievement" that Bågenholm's life could be saved. He believed the reason she was able to recover was that her metabolism slowed down during the incident and the tissues inside her body required less oxygen at the low temperatures. According to the journal Proto (published by the Massachusetts General Hospital), Bågenholm's metabolism slowed down to ten percent of its baseline rate and thus she barely needed any oxygen at all.
caption: A Sea King helicopter brought Bågenholm to the Tromsø University Hospital.
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