An Intraoperative Case of Spontaneous Restoration of Circulation from Asystole: A Case of Lazarus Phenomenon

Ekmektzoglou, Konstantinos; Koudouna, Eleni; Bassiakou, Eleni; Stroumpoulis, Konstantinos; Clouva-Molyvdas, Phyllis; Troupis, Georgios; Xanthos, Theodoros

doi:10.1155/2012/380905

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Although the biblical Lazarus rose from the dead without resuscitation attempts, there are no case reports of it occurring in someone who has died without CPR performed beforehand [9,33]. Almost all cases of autoresuscitation occurred after CPR following non-traumatic CA; there is only one report following traumatic CA [34] and four others associated with major haemorrhage [26,[35][36][37]. Therefore, it has been suggested that autoresuscitation is due to the medical interventions that were performed during resuscitation, but their effectiveness was delayed for some reason [38].…”

Section: Discussionmentioning

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: Discussionmentioning

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

View full text Add to dashboard Cite

show abstract

“…The Lazarus phenomenon has nothing to do with the trauma. 6 So far, two more cases of trauma have been reported. 7 8 What these cases have in common is that they were accompanied by severe chest injuries and PEAs were confirmed by cardiac arrest ECG rhythm.…”

Section: Discussionmentioning

confidence: 99%

Delayed Presentation of Spontaneous Shockable Rhythm After Death: Another Subtype of Lazarus Phenomenon?

Kim

2022

J Korean Med Sci

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Lazarus phenomenon was defined as spontaneous circulatory restoration after death. It is important because survival discharge is possible. A 44-year-old woman developed traumatic cardiac arrest. She was declared dead after 30 minutes of resuscitation. Suddenly, pulseless ventricular tachycardia was shown after 6 minutes of death declaration. Resuscitation with epinephrine injection was resumed but was terminated after 7 minutes, and she was declared dead once more. A case where an electrocardiography appears spontaneously should be classified as a subtype of the Lazarus phenomenon. If the transition from asystole to spontaneous shockable rhythm follows a mechanism similar to that of the Lazarus phenomenon, active resuscitation and monitoring for a period of time following death declaration should be considered.

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Lazarus Phenomenon or the Return from the Afterlife—What We Know about Auto Resuscitation

Rzeźniczek

Gaczkowska

Kluzik

et al. 2023

JCM

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Autoresuscitation is a phenomenon of the heart during which it can resume its spontaneous activity and generate circulation. It was described for the first time by K. Linko in 1982 as a recovery after discontinued cardiopulmonary resuscitation (CPR). J.G. Bray named the recovery from death the Lazarus phenomenon in 1993. It is based on a biblical story of Jesus’ resurrection of Lazarus four days after confirmation of his death. Up to the end of 2022, 76 cases (coming from 27 countries) of spontaneous recovery after death were reported; among them, 10 occurred in children. The youngest patient was 9 months old, and the oldest was 97 years old. The longest resuscitation lasted 90 min, but the shortest was 6 min. Cardiac arrest occurred in and out of the hospital. The majority of the patients suffered from many diseases. In most cases of the Lazarus phenomenon, the observed rhythms at cardiac arrest were non-shockable (Asystole, PEA). Survival time after death ranged from minutes to hours, days, and even months. Six patients with the Lazarus phenomenon reached full recovery without neurological impairment. Some of the causes leading to autoresuscitation presented here are hyperventilation and alkalosis, auto-PEEP, delayed drug action, hypothermia, intoxication, metabolic disorders (hyperkalemia), and unobserved minimal vital signs. To avoid Lazarus Syndrome, it is recommended that the patient be monitored for 10 min after discontinuing CPR. Knowledge about this phenomenon should be disseminated in the medical community in order to improve the reporting of such cases. The probability of autoresuscitation among older people is possible.

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An Intraoperative Case of Spontaneous Restoration of Circulation from Asystole: A Case of Lazarus Phenomenon

Cited by 3 publications

References 9 publications

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

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

Delayed Presentation of Spontaneous Shockable Rhythm After Death: Another Subtype of Lazarus Phenomenon?

Lazarus Phenomenon or the Return from the Afterlife—What We Know about Auto Resuscitation

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