Damar Hamlin’s ability to communicate with medical personnel and his family members after a heart attack Monday night bodes well for his brain’s recovery, according to the doctors and medical experts caring for him.

“This is a really good turn in his ongoing care,” said Dr. William Knight IV, director of emergency medicine at the University of Cincinnati Medical Center, who has been treating Mr. Hamlin since he collapsed on the field during the Buffalo Bills. ” -Cincinnati Bengals games. “But he still has significant progress that he needs to make.”

While experts have reason to speculate that Mr. Hamlin may be on a good path to neurological recovery, questions remain about the health of his other organs, including his lungs.

At a news conference on Thursday, Dr. Knight and Dr. Timothy A. Pritts said Mr. Hamlin was still critically ill, was in intensive care and was still lightly sedated and on a ventilator, and therefore unable to speak. But now he can communicate by nodding and nodding his head. He also wrote a question on a pad of paper, asking his nurse who had won the game.

Dr. Knight and Dr. Pritts said during the news conference that they were not yet sure why Mr. Hamlin had cardiac arrest during the game. But one explanation he hasn’t ruled out is that his bad luck was worse when he suffered a severe laceration to his chest when he collided with a Bengals receiver. When it occurs at precisely the 20-millisecond moment in the heart’s cycle, when the organ is relaxing and filling with blood, the shock can stop the heart.

The consequences can be dire, even if, as in Mr. Hamlin’s case, the person receives immediate cardiopulmonary resuscitation and his heart is restarted with a defibrillator.

“The big issue in cardiac arrest is no blood flow to the brain,” said Dr. Andrew Luks, a critical care and respiratory specialist at the University of Washington who is not involved in Mr. Hamlin’s care.

Although it is impossible to do a full neurological evaluation while Mr. Hamlin was on a respirator, “the fact that he followed orders and communicated in writing is very reassuring,” Dr. Luks said. “The potential for serious neurological damage is very small.”

“There’s every reason to think he’ll return to a normal neurologic function,” said Dr. Michael Mack, chairman of cardiovascular services at Baylor Scott & White Health in Dallas.

But recovery is not instantaneous, he said. Patients go through a phase where they are slow to process and respond to interactions.

Another major concern when a person has cardiac arrest is damage to the lungs, a serious injury called acute respiratory distress syndrome, or ARDS. One study The condition was found to develop in about half of people with cardiac arrest.

Sometimes CPR injures the lungs during repetitive, deep compressions of the chest wall. Patients can also inhale abdominal fluid or saliva into their lungs, which can cause injury. And poor blood flow during CPR can contribute to lung injury.

Mr. Hamlin did not escape this complication.

Dr. Douglas White, professor of critical care medicine at the University of Pittsburgh Medical Center, said there is no specific treatment for ARDS, other than making sure the ventilator is set to deliver shorter breaths than normal to prevent additional injury to the lungs. Is. Doctors then monitor patients and wait for them to recover, which can take days or weeks.

While most patients make a full recovery, some are left with scar tissue in their lungs, Dr. White said. For many people, scar tissue isn’t serious — but, he added, “for a world-class athlete,” who performs at physical extremes, “it’s a different problem.”

Doctor. White said when someone is on a ventilator for a week or more, scarring becomes a concern. As of now, Mr. Hamlin has been on a ventilator for three days.

“The next big milestone,” Dr. Pitts said, “will be to get him to breathe on his own.”

Mr. Hamlin’s doctors declined to predict when he would make a full recovery and whether he would be able to play football again. He said that he was just taking things day by day.

“It’s been a long and difficult road for the last three days,” Dr Knight said. Mr. Hamlin, he said, was “incredibly ill.”

But, he added, “he is now showing signs of good neurological recovery.”

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