Survival after prolonged hypothermia.

To the Editor: In February 1993 a six-year-old boy weighing 22 kg fell into a river in an alpine region near Innsbruck, Austria (air temperature, -4 °C; water temperature, 2.5 °C). He drifted away immediately and was not pulled out of the water until 65 minutes later by firefighters 6.5 km downstream, one of whom drowned during the rescue efforts. When rescued, the boy showed no signs of physical injury. Asystole was present, and the rectal temperature was 16.4 °C. He received basic life support while being transported to a hospital by helicopter. On admission, the boy's blood pH was . . .