Found without a pulse at 2.000 meters: this is how the Lombardy healthcare system saved the life of an 18-year-old thanks to an extraordinary intervention.

During the Marathon Trail Lago di Como, a young athlete goes into cardiac arrest at high altitude: the AREU air rescue team, Alpine Rescue, and Papa Giovanni XXIII Hospital combine their expertise and emergency technologies, culminating in the ECMO that restarts his heart.

A day of sport and passion for the mountains could have ended in tragedy. Instead, it became a story that symbolizes the excellence of Lombardy's healthcare system. Jiri Marzi, 18, an athlete from Griante, is alive today thanks to an extraordinary rescue operation involving air ambulances, Alpine Rescue, specialized technicians, intensive care physicians, and the ECMO team from the Papa Giovanni XXIII Hospital in Bergamo. A flawless machine that functioned flawlessly in extreme conditions.

The story was reconstructed at Palazzo Lombardia by the Welfare Councillor Guido Bertolaso, supported by the professionals who that day carried out an intervention considered – due to timing, coordination and clinical complexity – one of the most difficult of recent years.

A race that turns into an alarm

Saturday, September 27th, during the Marathon Trail Lake ComoJiri sets off at 8:30 a.m. from Menaggio, like hundreds of other trail running enthusiasts. The weather rapidly deteriorates, some sections of the route are cut for safety reasons, and visibility drops below 1900 meters. The last time he is seen is at 12:30 p.m.

When he doesn't show up at the scheduled checkpoint that afternoon, the organizers aren't unaware of the delay: they immediately raise the alarm. It's the first step in a race against time.

The rescue machine is activated within minutes

A massive search operation begins at 14.43pm:

• The teams of CNSAS extension they start the research, then other technicians join.
• The Como air rescue service takes off at 3:15 PM.
• Firefighters activate the helicopter Dragon, equipped with IMSI Catcher, a device capable of hooking up to cell phones even in extreme conditions.
• Weather conditions are further deteriorating, making any travel risky.
• At 17.26pm the call for the air rescue was made Sondrio, which takes off a few minutes later.

All 18.10, after nearly four hours of searching, Dragon He spots the young man on the ridge between Monte Bregagno and Sasso Bellarona, at 2.000 meters above sea level. There, the cold is biting, the wind is strong, and visibility is limited.

Found without a pulse at 21°C: high-altitude resuscitation begins

The scene that appears to the rescuers is dramatic: Jiri is without a heartbeatin asystolein deep hypothermia with a body temperature of 21°C. He is literally at the end of his life.

Doctor Gabriele Aletti, anesthesiologist and resuscitator at the Sondrio air rescue service, immediately begins ACLS maneuvers. The device is applied LUCAS, which ensures constant mechanical chest compressions. Despite the desperate conditions, the team doesn't give up: profound hypothermia, paradoxically, offers a chance of survival by slowing the metabolism and protecting the organs.

All 18.40 The flight to the Papa Giovanni XXIII hospital in Bergamo departs.

In Bergamo, the lifesaving procedure: ECMO

All 19.01 The young man arrives at the hospital. His condition is critical, but the Bergamo team wastes no time. 19.20, the boy comes cannulated and connected to theECMO —a machine that temporarily replaces the heart and lungs.

It is a complex procedure, reserved for extreme cases, which allows:

• oxygenate the blood externally,
• gradually warm up the body,
• allow organs to recover without permanent damage.

The surgery is a success: Jiri responds to therapy and his life is saved.

In the words of the protagonists: "An orchestra that played to perfection"

The commissioner Bertolaso He called the intervention "a magnificent example of cooperation between institutions, healthcare, and civil protection."

“When you play as a team, the results can be extraordinary. Jiri is alive thanks to professionals who are truly top players.”

Doctor Wings, first doctor to intervene on the boy:

"A rescue like this depends not only on the skill of individuals, but on the harmony of the team. It's like an orchestra: everyone has a fundamental role and must perform it to perfection."

Professor Luca Lorini, director of the Emergency Department of the ASST Papa Giovanni XXIII, underlined:

"Beyond the technique, there's an immense passion in the work of rescuers. A passion supported by an extremely high level of training."

The nursing coordinator Raffaella Gianoli highlighted the crucial role of communication:

“Communication between the air rescue team, ground teams, and operations centers was impeccable. This made the difference.”

An intervention that becomes a national model

The operation that saved Jiri is a textbook example of how a modern emergency system should work:

• reactive,
• technologically advanced,
• multidisciplinary,
• integrated between mountain, air and hospital.

From the mountain at 2.000 meters to an ECMO room, every step was crucial. It's proof that, when every mechanism works just right, even the seemingly impossible—like bringing a heartless boy back to life in the freezing cold of the mountains—can become a reality.