Doctor: Prognosis for revived toddler 'guarded'
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Dr. James Cappon
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(CNN) -- Twenty-month-old Mackayala Jespersen was moving her arms and legs Wednesday, days after she was pronounced drowned in the family swimming pool but then revived nearly two hours later.
CNN Anchor Daryn Kagan spoke with the toddler's doctor, critical care specialist Dr. James Cappon, about the long recovery ahead for Mackayala.
KAGAN: Doctor, let's start with an update on Mackayala's condition.
CAPPON: Well, Mackayala today [Wednesday] is in serious, but stable, condition in the pediatric ICU at Children's Hospital of Orange County.
KAGAN: I realize the story doesn't begin at this hospital. She was taken to another hospital where she was pronounced dead. But I think anybody following this little girl's story has to ask, how can this happen? What would possibly indicate... that she would appear dead when she was still alive?
CAPPON: Well, it's a difficult question to answer, and it is what everybody wants to know. Our suspicion is that she was relatively protected and somehow blunted by a fairly low body temperature, and by the time she got to Children's Hospital, she had warmed up to a degree that we could more reliably assess what her overall condition, particularly neurological condition, was.
KAGAN: You hear about children falling into cold water and surviving, but usually those are children you hear about in Minnesota, or Wisconsin, not southern California. Could that water possibly have been cold enough?
CAPPON: Oh, you're absolutely correct. And I don't want to have any sort of mistake made in that regard. This is very different from a pure ice water drowning situation that occurs in colder climates, in which you are basically instantly frozen. That can be very protective to your brain and allow you to get away with a long period of no oxygen or blood flow. This is different, and hence the prognosis is much more guarded and our uncertainty is quite significant.
KAGAN: Let's talk about that prognosis. It is a miracle that Mackayala is here and she's alive, but what kind of future does she have?
CAPPON: Well, she's already surprised us a great deal by, No. 1, her survival, as you mentioned. She's done some things in terms of overall progress in the last several days, including getting off the ventilator, that are not expected. She's done some neurological activities that, again, exceeded expectations. They would include breathing on her own, some movement of her arms and legs and even some eye opening. What we await and hope to see, but are not guaranteed is to see purposeful activities, activities that she is responding to making efforts in her own regard.
KAGAN: And it's kind of hard right now to tell exactly where she is because she's been sedated?
CAPPON: She has, although her improvements over the last several days, have allowed us to sedate her much less than we had before. So we're getting a more accurate and honest assessment of what her neurological status is.
KAGAN: I want to ask you a technical question about these brain scans. She's had brain scans, and the results would appear to be encouraging, but that doesn't tell the whole story, does it?
CAPPON: No, a brain scan, a CT scan, for instance, is merely a picture, albeit a very good one, of what a given organ, brain in this case, would look like. Similarly, she had an EEG, an electroencephalogram, which looks at brain wave activity, which helps describe what she is or perhaps is not doing, but ultimately, it comes down to function, what this child, or child like her is doing clinically at the bedside.
KAGAN: And how much is age on her side? That's a big help, is it not?
CAPPON: You know, it's surprising that it's not as much as is commonly thought. It is no better for a child than an adult to sustain a full cardiopulmonary arrest. Resuscitation results are not better than the adult population, and you don't grow new brain cells regardless of age.
KAGAN: And finally, I just have to ask, how her parents are doing? I can't even begin to imagine hat they have been through over the last few days.
CAPPON: Well, they've been through a lot, and they are good, solid people, surrounded by a family that's very supportive. I think they are in a well-centered place, in the sense they are not overly pessimistic nor overly optimistic, and they're grateful to what occurred so far, and they're looking forward to the future and hopeful for the best.
KAGAN: But to be realistic, this family still has a long road ahead of them?
CAPPON: No question, and that road will probably be slow, it may not always be steady, and we can't guarantee what the future is.
KAGAN: Well, Dr. Cappon, we wish you and the doctors at Children's Hospital in Orange County the best in treating Mackayala and our best to the Jefferson family as well.
