...e so severe and her blood loss so massive it ould have been impossible for her to survive, British doctors said Sunday. As details emerged about the accident that killed the princess and her millionaire Egyptian companion Dodi Fayed in Paris, medical experts in London heaped praise on their French counterparts and said they had done everything possible to save her life. I think one ould say they ere unsurvivable injuries, said Alaistair ilson, the director of emergency services at the Royal London Hospital. The French ambulance service, the people doing the extrication from the mangled reck and the hospital certainly appear to me to have done extremely ell. On the evidence Ive got, they get top marks for doing all and a bit more, he added. Diana, 36, died of cardiac arrest after doctors at Paris Hospital La Pitie Salpetriere repaired a tear in a ruptured pulmonary vein and massaged her heart for to hours in an effort to get it pumping again. Last-ditch attempts not rareDoctors last-ditch attempts to save Diana, including the lengthy heart massage, are considered extreme but hardly rare, especially for healthy young victims of auto accidents. hen Diana arrived at the hospital, she as bleeding heavily from the chest. Dr. Bruno Riou, head of the hospitals intensive care unit, said doctors opened her chest and found an important ound of the left pulmonary vein, hich carries blood from the lungs to the heart. The ound, the apparent source of the bleeding, as closed. The doctors tried to revive her ith the chest massage -- first externally and then directly to the heart -- but it failed and she as declared dead about four hours after the crash. Not just celebritiesIts not just celebrities ho get that kind of treatment, said Dr. Thomas Martin, an emergency medicine specialist at the University of ashington Medical Center in Seattle. Its probably not much different than ould be done for any other young healthy person. hen the heart stops beating, doctors have about four minutes to restore blood flo before permanent brain damage sets in. Even if the heart fails to begin pumping again on its on, hoever, doctors can often prevent brain injury by pushing on the heart to restore circulation. In cases of cardiac arrest folloing multiple severe injuries, such as bad car crashes, doctors may open up the chest both to look for sources of bleeding and to give them direct access to the heart. Standard cardiopulmonary resuscitation -- CPR -- performed externally on the chest, typically pumps about 10 percent of the usual amount of blood. But massaging the naked heart directly can achieve almost normal circulation. Opening up the chest is only done as a last-resort measure to try to salvage somebody. But if you dont open up the chest, you might as ell pronounce them dead, said Dr. David Frankle of Cedars-Sinai Medical Center in Los Angeles. Victims age a factorTypically, depending on the case, after 30 or 40 minutes, you ould stop, said Dr. Kathleen Raftery of Brigham and omens Hospital in Boston. One exception is if the heart resumes beating on its on for a fe minutes and then stops again. In such cases, doctors might keep massaging the heart for several hours, hoping to revive the victim. Doctors say they ill go to great extremes in such cases, especially if the victims are young. In older victims, resuscitation attempts are often complicated by clogged arteries, hich impair the flo of the manually pumped blood to the brain. But the young sometimes are able to come through such extreme trauma reasonably ell. This can be especially true in situations here damage to a major blood vessel is causing bleeding near the heart. Sometimes if you get in quickly and clamp it off, you can dramatically resuscitate these people, said Martin. Thats probably hy they ent to the unusual step of opening the chest. Pulmonary vein crucialRiou, from the Paris hospital, told reporters the surgeons stopped trying to restart her heart after massive internal bleeding in the chest, despite repairs to the ruptured left pulmonary vein. The pulmonary vein is one of the most important because of its close proximity to the heart. Blood flos aay from the heart in arteries and back to it in veins. The left pulmonary vein, ilson said, bleeds a lot if it gets torn and it can let air into the left side of the heart, hich means air can be pumped into the body, so it is an extremely dangerous injury indeed. Doctors first tried to revive the princess at the scene of the accident in a road tunnel in the French capital and surgeons later opened up her chest to perform a thorocotomy -- surgery to repair the pulmonary vein to stop the bleeding. Right hospital at the right timeClearly they found that there as something they could do hich they felt could save her life and they ere absolutely right in that. I believe they must have had the right surgeons in the right hospital at the right time, ilson said. But he said that due to a number of factors -- other injuries, blood loss, air that got into her system -- they ere unable to save her. After a cardiac arrest it is really difficult to resuscitate people, he added. John Pepper, a consultant cardiac surgeon at Londons Brompton Hospital, said the French doctors had tried to control the bleeding, but Dianas heart as already functioning badly and as too severely damaged. hen the pulmonary vein ruptures you can lose a huge amount of blood in a very short time, he said. The HYPERLINK http7.cnn.cominteractiveslegal.html tl AP Associated Press and HYPERLINK http7.cnn.cominteractiveslegal.html tl Reuters Reuters contributed to this report. Alex M IX b-0tsCFS245npqrst79789NO 5CJ OJQJtJaJ CJ OJQJJaJ mHnHuajCJ OJQJUJaJ mHnHuCJ OJQJJaJ yaCJ OJQJJaJ ajCJ OJQJUJaJ 8n9r20laàaIfIfFaddIfitIfIfaIfakIfks OklnoIa67à . K O P s CJ OJQJJaJ ya0J6CJ OJQJsJaJ !aj0JCJ OJQJUJaJ 0JCJ OJQJJaJ CJ OJQJJaJ ajCJ OJQJUJaJ 0JCJ OJQJJaJ axcE0Fa2ntnJM t IfBIfaBIfaIft s s ...
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