Autoresuscitation: A Case and Discussion of the Lazarus Phenomenon

Hannig, Kjartan Eskjær; Hauritz, Rasmus Wulff; Grove, Erik Lerkevang

doi:10.1155/2015/724174

Cited by 14 publications

(11 citation statements)

References 19 publications

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“…Careful consideration of how long CPR has been employed before TOR PROCEDURAL Unobserved minimal vital signs (e.g. pseudo-PEA) due to clinician oversight [38,81]. Misdiagnosis of death, perhaps due to failure to fully examine patient prior to declaring death.…”

Section: Spontaneousmentioning

confidence: 99%

Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review

Gordon

Pasquier

Brugger

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: Autoresuscitation describes the return of spontaneous circulation after termination of resuscitation (TOR) following cardiac arrest (CA). We aimed to identify phenomena that may lead to autoresuscitation and to provide guidance to reduce the likelihood of it occurring. Materials and methods: We conducted a literature search (Google Scholar, MEDLINE, PubMed) and a scoping review according to PRISMA-ScR guidelines of autoresuscitation cases where patients undergoing CPR recovered circulation spontaneously after TOR with the following criteria: 1) CA from any cause; 2) CPR for any length of time; 3) A point was reached when it was felt that the patient had died; 4) Staff declared the patient dead and stood back. No further interventions took place; 5) Later, vital signs were observed. 6) Vital signs were sustained for more than a few seconds, such that staff had to resume active care. Results: Sixty-five patients with ROSC after TOR were identified in 53 articles (1982-2018), 18 (28%) made a full recovery. Conclusions: Almost a third made a full recovery after autoresuscitation. The following reasons for and recommendations to avoid autoresuscitation can be proposed: 1) In asystole with no reversible causes, resuscitation efforts should be continued for at least 20 min; 2) CPR should not be abandoned immediately after unsuccessful defibrillation, as transient asystole can occur after defibrillation; 3) Excessive ventilation during CPR may cause hyperinflation and should be avoided; 4) In refractory CA, resuscitation should not be terminated in the presence of any potentially-treatable cardiac rhythm; 5) After TOR, the casualty should be observed continuously and ECG monitored for at least 10 min.

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Section: Spontaneousmentioning

confidence: 99%

Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review

Gordon

Pasquier

Brugger

et al. 2020

Scand J Trauma Resusc Emerg Med

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“…Several mechanisms have been proposed as the predisposing factors for the Lazarus phenomenon including auto-PEEP/hyperinflation, spontaneous return of myocardial perfusion, delayed action of drugs administered during CPR, hyperkalemia, spontaneous termination of ventricular fibrillation, functional recovery of myocardium after prolonged myocardial dysfunction, or hypothermia [ 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

When a Dead Patient Is Not Really Dead: Lazarus Phenomenon

Sharma¹,

Chandna

Nguyen³

et al. 2020

Case Reports in Critical Care

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Lazarus phenomenon refers to autoresuscitation of a patient declared dead after cessation of cardiopulmonary resuscitation (CPR). The Lazarus phenomenon is rarely encountered and pathophysiology is not very well understood, but physicians need to be aware of this phenomenon. It is prudent that a physician leading a CPR effort waits for some time and monitors the patient further using blood pressure and electrocardiogram before confirming that a patient is actually dead.

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“…Autoresuscitation, also known as the Lazarus syndrome or Lazarus phenomenon, is the spontaneous return of circulation after cardiac arrest and is incidentally seen after failed cardiopulmonary resuscitation (CPR) [ 2 , 3 ]. The occurrence of this phenomenon may be widely underreported, as illustrated by the fact that almost 50% of French emergency physicians claim to have encountered autoresuscitation in clinical practice, and more than one-third of Canadian intensivists have seen at least 1 case of autoresuscitation.…”

Section: Introductionmentioning

confidence: 99%

“…The occurrence of this phenomenon may be widely underreported, as illustrated by the fact that almost 50% of French emergency physicians claim to have encountered autoresuscitation in clinical practice, and more than one-third of Canadian intensivists have seen at least 1 case of autoresuscitation. The true incidence remains unknown [ 3 ].…”

Section: Introductionmentioning

confidence: 99%