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British Audrey Mash and her husband Rohan Schoeman speak with medical staff at Vall d'Hebron hospital in Barcelona, Spain, December 5, 2019. Picture taken December 5, 2019. REUTERS/Stringer NO RESALES. NO ARCHIVES. Image Credit: REUTERS

LONDON - Audrey Mash’s life was hanging in the balance. Her heart had stopped beating when she was caught in a snowstorm on a hike in the Spanish Pyrenees with her husband and when she arrived at a Barcelona hospital she had no vital signs.

“I was trying to feel a pulse,” her husband, Rohan Schoeman, told Catalan news Channel TV3. “I couldn’t feel a breath. I couldn’t feel a heartbeat.”

When Mash, a 34-year-old English-language teacher, arrived at Vall d’Hebron Hospital last month, “she was blue and cold and she had no vital signs,” Dr. Eduard Argudo, who helped treat her, said in an interview Friday.

But after she spent six hours in cardiac arrest, doctors managed to restart Mash’s heart and save her life with the aid of a highly specialised tool.

Mash’s experience will go down in the record books in Spain as the longest period of cardiac arrest in which the patient survived, doctors said.

She appeared at a news conference in Barcelona and stood smiling while surrounded by the doctors and members of the rescue teams that had worked to save her life. She said she felt happy and grateful to be alive.

“I am the lucky one,” she said. “I’m the one who didn’t have to do anything.”

Caught in a snowstorm

Mash, a Briton who lives in Barcelona, had gone on the hike in early November with her husband but when the snowstorm hit on the trail, they lost their way in the inclement weather and clung to each other, trying to shelter from the wind and cold.

Her body temperature dropped sharply, she developed severe hypothermia and she ultimately went into cardiac arrest.

First, she began to “talk nonsense,” her husband told Channel TV3. Then, she had trouble moving. Later, she became unconscious.

By the time the emergency workers rescued the couple, Mash’s body temperature was 64 Fahrenheit. The average body temperature is 98.6 degrees Fahrenheit.

A helicopter rescue team airlifted her to Vall d’Hebron, where a team of doctors mobilised to save her life.

Core temperature plummets... and is a life-saver

Medical journals have long noted the cases of people who have emerged from years-long comas. And medical studies of hypothermic cardiac arrests in Norway have explored the cases of patients who have survived after their core body temperature dropped to 56 degrees Fahrenheit and they spent nearly seven hours in that condition.

Mash’s hypothermic condition not only stopped her heart for six hours but it also protected her brain and other organs from damage, doctors said.

“If she had been in cardiac arrest for that long with a normal body temperature, she would have died,” Argudo said

Argudo, who had been called back to the hospital to attend to the unusual case after ending a 24-hour shift, said his team deployed a specialist tool that has never before used on a patient in hypothermic cardiac arrest in Spain: an extracorporeal membrane oxygenation machine, known as Ecmo.

The machine takes blood from the patient, infuses it with oxygen and then reintroduces it to the body and circulates it around the bloodstream. It is more commonly used to treat infants with breathing or heart problems.

It also allows doctors to control the blood’s temperature, so they slowly increased it until Mash’s body temperature reached a point where they could use a defibrillator to shock her heart into beating normally again.

The medical team had prepared her husband for the possibility that she could experience brain damage when she woke up but that was dispelled when she was taken off sedation two days after the rescue.

“We were really happy and surprised when she woke up and immediately asked, ‘What am I doing here?’ and ‘Who are you?’” Dr. Jordi Rivera, the director of the Ecmo program at Vall d’Hebron Hospital, said.

But beating all expectations of a long period of healing, she has made a near-full recovery. Mash was discharged from the hospital 12 days after her rescue.

She plans to return to work on Wednesday, but before that she will try to go for a run this weekend, she said in a phone interview Friday.

‘I do not have the memory’

Mash remembers nothing about the traumatic experience. Her last memory before waking up in the intensive care unit is of heading off to hike with her husband.

“People keep asking me how I feel it has changed me, but I do not have the memory,” she said in the interview. “I never considered the fact that I might die. But it is different for my husband and parents - they were in a very stressful situation.”

Born in Britain, she spent part of her childhood in South Africa, where she met her husband, and has also lived in China. The couple moved to Barcelona two years before the hiking rescue.

She is a keen hiker and tries to go to the mountains with her husband at least once a month and has previously trekked in the Himalayas. Doctors said that her experience there might have helped her to survive, in addition to her young age and active lifestyle.

“There is very low levels of oxygen in the Himalayas, so her body was in some way prepared for this,” Rivera said.

The hypothermia has left Mash with some mobility and sensitivity issues in her fingers, which means she cannot do up buttons on her own or put earrings in herself, she said, but she hopes that will improve.

She praised the 40 people involved in her rescue and medical treatment as “absolute heroes who should be in the limelight for this.”

While near-death experiences can prompt some people to reassess their priorities in life, she said that was not her style.

“There is nothing I am going to be changing about my life,” Mash said. “I like my life. I have good friends; I love my job and my husband. If anything, it has made me realise how much I do not want to lose that.”

The experience has also not deterred her from one of her favourite activities.

“I hope that in spring we will be able to start hiking again,” Mash said. “I don’t want this to take away that hobby from me.”

But she will steer clear of the mountains in winter.

The New York Times News Service