Lazarus phenomenon: Knowledge, attitude and practice

Gerard, D. L.; Vaux, J.; Boche, Thévy; Chollet-Xémard, C.; Marty, J.

doi:10.1016/j.resuscitation.2013.07.030

Cited by 17 publications

(15 citation statements)

References 5 publications

(4 reference statements)

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“…We agree that autoresuscitation events are probably under-reported [1, 13]. The under-reporting together with the low incidence of these events, hamper the elucidation of the pathophysiologic mechanisms involved.…”

Section: Discussionmentioning

confidence: 62%

“…The delayed return of spontaneous circulation (ROSC) after cessation of cardiopulmonary resuscitation (CPR) measures, also known as autoresuscitation, is known to most emergency physicians and intensive care specialists [1]. Cases in adults and children are reported regularly in which spontaneous circulation ensued several minutes after all supportive measures were withdrawn [2–9].…”

Section: Introductionmentioning

confidence: 99%

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Is increased positive end-expiratory pressure the culprit? Autoresuscitation in a 44-year-old man after prolonged cardiopulmonary resuscitation: a case report

Hagmann

Oelmann²,

Stangl³

et al. 2016

J Med Case Reports

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BackgroundThe phenomenon of autoresuscitation is rare, yet it is known to most emergency physicians. However, the pathophysiology of the delayed return of spontaneous circulation remains enigmatic. Among other causes hyperinflation of the lungs and excessively high positive end-expiratory pressure have been suggested, but reports including cardiopulmonary monitoring during cardiopulmonary resuscitation are scarce to support this hypothesis. Case presentationWe report a case of autoresuscitation in a 44-year-old white man after 80 minutes of advanced cardiac life support accompanied by continuous capnometry and repeated evaluation by ultrasound and echocardiography. After prolonged cardiopulmonary resuscitation, refractory electromechanical dissociation on electrocardiogram and ventricular akinesis were recorded. In addition, a precipitous drop in end-tidal partial pressure of carbon dioxide was noted and cardiopulmonary resuscitation was discontinued. Five minutes after withdrawal of all supportive measures his breathing resumed and a perfusing rhythm ensued.ConclusionsUnderstanding the underlying pathophysiology of autoresuscitation is hampered by a lack of reports including extensive cardiopulmonary monitoring during cardiopulmonary resuscitation in a preclinical setting. In this case, continuous capnometry was combined with repetitive ultrasound evaluation, which ruled out most assumed causes of autoresuscitation. Our observation of a rapid decline in end-tidal partial pressure of carbon dioxide supports the hypothesis of increased intrathoracic pressure. Continuous capnometry can be performed easily during cardiopulmonary resuscitation, also in a preclinical setting. Knowledge of the pathophysiologic mechanisms may lead to facile interventions to be incorporated into cardiopulmonary resuscitation algorithms. A drop in end-tidal partial pressure of carbon dioxide, for example, might prompt disconnection of the ventilation to allow left ventricular filling. Further reports and research on this topic are encouraged.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Is increased positive end-expiratory pressure the culprit? Autoresuscitation in a 44-year-old man after prolonged cardiopulmonary resuscitation: a case report

Hagmann

Oelmann²,

Stangl³

et al. 2016

J Med Case Reports

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“…In France, 103 prehospital emergency care physicians completed a survey related to the Lazarus phenomenon in 2013 [15]. The existence of autoresuscitation was known by 69% of respondents.…”

Section: Relation Of Results To Other Studiesmentioning

confidence: 99%

Delayed return of spontaneous circulation (the Lazarus phenomenon) after cessation of out-of-hospital cardiopulmonary resuscitation

et al. 2017

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“…medikolegale konsekvenser (4). En spørreundersøkelse blant franske akuttmedisinere fra 2013 indikerer en slik underrapportering, idet 45 % svarte at de hadde opplevd dette fenomenet selv (7). Fenomenet er mye hyppigere beskrevet i ikkemedisinsk enn medisinsk litteratur: 10 000 ganger i perioden 1982 -2009, sammenliknet med 45 ganger ifølge fem søkemotorer brukt av Wiese og medarbeidere (5).…”

Section: Forekomst Av Autoresusciteringunclassified

Lasarus-fenomenet

Kongsgaard¹,

Steen²

2014

Tidsskriftet

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Lazarus phenomenon: Knowledge, attitude and practice

Cited by 17 publications

References 5 publications

Is increased positive end-expiratory pressure the culprit? Autoresuscitation in a 44-year-old man after prolonged cardiopulmonary resuscitation: a case report

Is increased positive end-expiratory pressure the culprit? Autoresuscitation in a 44-year-old man after prolonged cardiopulmonary resuscitation: a case report

Delayed return of spontaneous circulation (the Lazarus phenomenon) after cessation of out-of-hospital cardiopulmonary resuscitation

Lasarus-fenomenet

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