Limited or no literature exists that describes. It is widely accepted that asystole for more than 20 minutes without reversible factors is a reasonable cause for stopping CPR [13]. The Lazarus effect is when someone a healthcare provider has declared dead suddenly regains blood flow and appears to come back to life. In general, CPR should continue as long as shockable rhythm or the other reversible cause for cardiac arrest persists [, An example of the Lazarus phenomenon with its background and possible countermeasures is discussed below (summarized in Box. Tretter JT, Radunsky GS, Rogers DJ, et al.. P-75 two successful cases of spontaneous recovery after cessation of CPR. Recovery after discontinued cardiopulmonary resuscitation, A systematic review of autoresuscitation after cardiac arrest. J. T. Niemann, S. J. Stratton, B. Cruz, and R. J. Lewis, Outcome of out-of-hospital postcountershock asystole and pulseless electrical activity versus primary asystole and pulseless electrical activity, Critical Care Medicine, vol. Upon arrival, he was defibrillated again. A 66-year-old man suffered a ventricular fibrillation cardiac arrest after an episode of chest pain. 1993;78(5):p. 991. The reason for these can be attributed to the fact that medicolegal1,5,7 issues are brought to light in cases which are pronounced dead which later turn out to have been alive. sharing sensitive information, make sure youre on a federal Sharma M, Chandna M, Nguyen T, Vakil A, Franco R Jr, Ratnani I, Varon J, Surani S. Case Rep Crit Care. Myocardial reperfusion as a consequence of return of spontaneous circulation can occur due to the spontaneous dislodging of embolised endovascular plaque from the coronary artery. Supplementary Video 2: Apical 4-chamber ECHO view. Only articles which identified cases where return of spontaneous circulation occurred after cessation of Cardiopulmonary Resuscitation (CPR) and review articles on the entity were included. Kuisma M, Salo A, Puolakka J, Nurmi J, Kirves H, Vyrynen T, Boyd J. Resuscitation. E. F. M. Wijdicks, Brain Death, Lippincott Williams, and Wilkins, Philadelphia, 2001. Unauthorized use of these marks is strictly prohibited. Often, pulse palpation can be challenging or nearly impossible. K. Hornby, L. Hornby, and S. D. Shemie, A systematic review of autoresuscitation after cardiac arrest, Critical Care Medicine, vol. The administration of bicarbonates shifts the patient towards homeostasis, and there is exhalation of CO2 due to a shift in equilibrium towards alkalosis. The "Lazarus phenomenon" is an unusualsyndrome with a difficult pathophysiological explanation, defined as the spontaneous return of circulationin the absence of any life support technique or after the cessation of failed CPR maneuvers. 84, no. K. Karamchandani, J. Leathem, and E. Sinz, Acute adrenal insufficiency in the perioperative period: a case report, A & A Practice, vol. Epub 2017 Jul 24. 28, no. The decision to stop is based on patient preferences, time before initiation of CPR, primary rhythm, comorbidity (including prognosis of underlying cause of cardiac arrest), and duration of resuscitation. The pCO2 on the first venous sample obtained in hospital was 3.43kPa, which may represent hyperventilation (including auto-PEEP) but could also be influenced by reduced cardiac output. The physiology of severe auto-PEEP is similar to pericardial tamponade [2]. Conversely, since his final dose of adrenaline was given 13min prior to ROSC, the reduced influence of this drug onthe pulmonary artery and right heart function may have been beneficial.15. This site needs JavaScript to work properly. Some have suggested that during resuscitation increased positive end-expiratory pressure (PEEP) may develop in the airways due to inadequate time given for complete exhalation.4 12 That patients are often overventilated during CPR, even if delivered by experienced personnel, is well recognised,13 leading to increased intrathoracic pressure, decreased venous return and subsequently reduced cardiac output.5 12 Our patient was managed as per ALS guidelines from the time he was attended to by paramedics and then by experienced ED staff. -, Linko K., Honkavaara P., Salmenpera M. Recovery after discontinued cardiopulmonary resuscitation. Accessibility 3, no. Myocardial ischemia is caused by a deficiency or loss of adequate perfusion to the myocardium. The temperature of this patient was recorded to be 31.4. It is probably due to rapid manual ventilation with inadequate time for exhalation, leading to elevated end-expiratory pressure (auto-PEEP) [2]. 5, no. An official website of the United States government. This case was that of a 36-year-old woman with a cardiac arrest secondary to a serious asthma attack. CT head revealed areas of acute infarct seen involving the brain stem as well as the cerebellar hemispheres and moderate enlargement of the ventricular system with left-sided intraventricular hemorrhage (Figures 2 and 3). In healthy individuals, the normal range for end-tidal CO2 is 4.656.0kPa (3545mmHg). DC: direct current. The emergency medical services (EMS) were called at 15:10 hours and an ambulance arrived at 15:13 and the emergency physician at 15:15. In medicine, Lazarus is the patient who, believed dead, spontaneously starts to circulate blood. VF: ventricular fibrillation. C. D. Deakin, J. P. Nolan, J. National Library of Medicine A generally fit 66-year-old man with a history of well-controlled hypertension and type 2 diabetes collapsed with chest pain. Surgery was concluded, and the patient was transferred to the intensive care unit. This particular case was reported to have had a complete recovery of higher cortical functions 10min subsequent to cardiac arrest.1, Recreational drug1,5 use, asystole, multiple trauma, intoxication and drowning have also been reported to be diagnoses at the time of death in patients exhibiting autoresuscitation.2 Autopsy findings in a case exhibiting autoresuscitation revealed early inferior wall myocardial infarction and hypoxic brain damage.4. This phenomenon was named after the biblical figure who was resurrected by Jesus 4 days after his death [ 1 ]. P. Dutta, A. Bhansali, S. R. Masoodi, S. Bhadada, N. Sharma, and R. Rajput, Preliminary data: PIM and Prism in infants and children post cardiac surgery in a UK PICU, Critical Care, vol. However, evidence is limited and prospective studies would be welcome to allow firmer recommendations. ECG: electrocardiogram. Moreover, guidelines for temperature monitoring from the American Society of Anesthesiologists state that every patient receiving anesthesia shall have temperature monitored when clinically significant changes in body temperature are intended, anticipated, or suspected [6]. Hyperinflation (resuscitative efforts)elevated intra-thoracic pressure gas trapping increased positive end-expiratory pressure (auto-PEEP)delayed venous return to the heart reduced cardiac outputcardiac arrest (in cases of obstructive pulmonary disease). Thirty in-hospital patients with life-threatening conditions were treated using this technique and the results reported by the author, in general, pointed towards the conclusion that this is a viable method to induce spontaneous return of circulation in patients with life-threatening pathologies such as: severe arterial hypertension, ischaemia, crushed chest, skull trauma, post-surgical shock, gas embolism, sepsis-induced renal failure and ventricular fibrillation. 1, article 14, 2020. Autoresuscitation in a 44-year-old man after prolonged cardiopulmonary resuscitation: a case report. C. Sasson, M. A. M. Rogers, J. Dahl, and A. L. Kellermann, Predictors of survival from out-of-hospital cardiac arrest a systematic review and meta-analysis, Circulation: Cardiovascular Quality and Outcomes, vol. 12, pp. Before A period of careful observation to confirm death subsequent to discontinuation of resuscitation to provide appropriate medical care, regardless of the duration or quality of the advanced life-supporting efforts instituted. A possible way to categorise the mechanisms of the Lazarus phenomenon can be to group the aetiologies into those said to be explained post-true cardiorespiratory arrest and those in the absence of the same based on certain other factors such as overlooking minimal vital signs on the part of the physician. Journal of the Royal Society of Medicine. 98101, 2016. the contents by NLM or the National Institutes of Health. On postoperative day 4, the patient was transferred to a regular room on the 2L nasal cannula. Scand J Trauma Resusc Emerg Med. Cardiopulmonary resuscitation (CPR) was commenced, biphasic direct current (DC) shocks weredelivered and adrenalinewas administered as per advanced life support (ALS) guidance. Adanal M, Gven TS, Kale MY, Ona S, Hsenyinolu , Karaba Y, et al. eCollection 2021 Aug. Maleck WH, Piper SN, Triem J, Boldt J, Zittel FU. Would you like email updates of new search results? 100%. Kmrinen A, Virkkunen I, Holopainen L, et al.. Spontaneous defibrillation after cessation of resuscitation in out-of-hospital cardiac arrest: a case of Lazarus phenomenon, Risen from the dead: a case of the Lazarus phenomenon-with considerations on the termination of treatment following cardiac arrest in a prehospital setting, Diagnosis of death after cessation of cardiopulmonary resuscitation, Death by hyperventilation: a common and life-threatening problem during cardiopulmonary resuscitation. In 2010, a team at McGill University conducted an extensive review of medical literature and found just 32 cases of the Lazarus Phenomenon since 1982. The patient did not have a shockable rhythm throughout the cardiac arrest. -, Adhiyaman V, Adhiyaman S, Sundaram R. The Lazarus phenomenon. 14451451, 2010. Disclaimer. However, evidence is limited and prospective studies would be welcome to allow firmer recommendations. Since the number of cases reported is small, there is a paucity of data to review and explanations of aetiology are very much theoretical. Lastly, we are aware that increasingly there are facilities to take selected patients in VF arrest to the Catheter Laboratory, often using mechanical CPR devices. Bethesda, MD 20894, Web Policies The term Lazarus phenomenon was first coined by Bray in 1983 because of its resemblance to the biblical story of Lazarus. Countermeasure. The cardiac conduction is slowed and the heart stops in diastole refractory to resuscitation. The abdominal cavity was closed. D. Gerard, J. Vaux, T. Boche, C. Chollet-Xemard, and J. Marty, Lazarus phenomenon: knowledge, attitude and practice, Resuscitation, vol. Intraoperatively, the patient suddenly started becoming bradycardic and went into asystole. doi: 10.1136/bcr-2017-219203. EMS: emergency medical services. Such cases are probably underreported due to medicolegal concerns. 2007;100(12):552557. The .gov means its official. This is described as the Lazarus phenomenon [2]. Hornby K., Hornby L., Shemie S. D. A systematic review of autoresuscitation after cardiac arrest. Sharma M, Chandna M, Nguyen T, Vakil A, Franco R Jr, Ratnani I, Varon J, Surani S. Case Rep Crit Care. 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. Extended periods of myocardial dysfunction following an episode of myocardial ischemia can occur. Survival from out-of-hospital cardiac arrest remains poor with only 7.6% being alive to discharge from hospital [8]. Lazarus phenomenon embodies auto-resuscitation, aka the return of spontaneous circulation following termination of cardiopulmonary resuscitation. There is no doubt that Lazarus phenomenon is a reality but so far the scientific explanations have been inadequate. The patient was found to have infarcted distal ileum and right colon secondary to scarred adhesion and inflammatory response involving VP shunt. The contractility of the musculature is depressed, there is hypotension and reduced hepatic blood flow. 552557, 2007. Our patient had a history of adrenal insufficiency requiring the chronic use of hydrocortisone. FOIA The cardiology team was recalled, a rapid sequence induction was performed, the patient was reintubated and transferred to the Catheter Laboratory. INTRODUCTION: The Lazarus Phenomenon, also known as auto-resuscitation, is a rare event where cessation of CPR results in a delayed return of spontaneous circulation (ROSC). CTE contributed to data acquisition and design and drafting of the manuscript. Bookshelf FOIA 3, pp. The endotracheal tube was removed as it appeared distressing to the relatives, and the patient developed pulseless electrical activity before monitoring was disconnected. A reported case attributing the return of spontaneous circulation to mild hypothermia describes the resuscitative efforts to have been conducted on a windy, chilly day, outdoors which was incidentally where emergency medical personnel conducted their resuscitative efforts. 2015, Article ID 724174, 5 pages, 2015. BLS: basal life support. N. Samudra and S. Figueroa, Intractable central hyperthermia in the setting of brainstem hemorrhage, Therapeutic Hypothermia and Temperature Management, vol. Ballesteros Pena S, Aedo F I, Lorrio Palomino S. Spontaneous return of circulation after termination of cardiopulmonary resuscitation maneuvers: a systematic review of cases of Lazarus phenomenon. Thirdly, a significant abrupt and sustained increase in end-tidal CO2 during CPR from initial baseline (e.g., increase exceeding 1.35kPa = 10mmHg) may be seen as the first indicator of ROSC. The patients mean arterial blood pressure was noted to be 60mmHg without any vasopressor agents and heart rate was 62bpm, sinus rhythm with spontaneous respiration at a rate of 12 breaths per minute. Preoperative records showed that her mean arterial blood pressure was ranging from 60 to 65mmHg, heart rate was ranging from 70 to 82 normal sinus rhythm, the temperature was 98.4F, and oxygen saturation was 96-98 on room air. 13051352, 2010. Perhaps, hyperventilation should be the fifth H in the list of potentially reversible causes of cardiac arrest. Case presentation Acute Med 2014; 4: 99102. Thus, the patient was pronounced dead and all resuscitation efforts were ceased. Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review. CPR: cardiopulmonary resuscitation. An official website of the United States government. Many of the same cases appear in both reports. 1 Lazarus phenomenon is defined as the unassisted return of spontaneous circulation after cardiac arrest. In skilled hands, lung ultrasound is a faster and more sensitive diagnostic test than chest X-ray [7]. Trauma surgeons and physicians, who are constantly dealing with emergency situations, should be aware of such an occurrence, the pathophysiology surrounding it and the medico-legal implications that it entails. Sprenkeler DJ, van Hout GPJ, Chamuleau SAJ. Primary percutaneous coronary intervention (PPCI) performed via the right radial artery confirmed proximal occlusion of the right coronary artery which was treated with three drug eluting stents. This has been noted in cases with refractory cardiac arrest in which CPR efforts were instituted.3, After autoresuscitation, patients have made neurological recovery to place them in the cerebral performance category of 12.12 Another case was reported to have been placed in a CPC of 3.7, The concept of neurological recovery has been compared to hibernation, where certain mammals survive in conditions mimicking those of cardiac arrest without neurological damage. This reason had led us to postulate that extra body heat necessary for the rewarming process was provided by her later found brain stem hemorrhage. Death implies the loss of the integrated function of all organ systems. Before ECG: electrocardiogram. The cases of reported Lazarus phenomenon have had certain factors which were commonly present in conjunction or individually in patients who demonstrated this phenomenon. Although there have been a handful of such cases reported, t This gradual increase of intrathoracic pressure leads to decreased venous return to the heart (preload) and subsequently low cardiac output and cardiac arrest, even in the presence of a perfusable cardiac rhythm [1, 2, 7]. This situation remained unchanged over the next 5 min afterwhich the respiratory rate surprisingly began to rise. Timeline. Unobserved minimal vital signs likely represent another explanation, when the circulation is present again. This review intends to systematically present current and past knowledge on this rare but definitive phenomenon. Research databases namely Google Scholar, Science Direct, Medline and PubMed were utilized. [Lazarus phenomenon. Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review. Resuscitation continued as per ALS guidance (including amiodarone, magnesium and stacked DC shocks), but the patient remained in refractory VF. Critical Care Medicine. 5, pp. V. Adhiyaman, S. Adhiyaman, and R. Sundaram, The Lazarus phenomenon, Journal of the Royal Society of Medicine, vol. Countermeasure. Since 1982, more than 20 patients with return of spontaneous circulation after cessation of cardiopulmonary resuscitation (Lazarus phenomenon) have been published. 228230, 2012. Section 4. A possible explanation may be that epinephrine stimulates the sodium potassium pump (Na-K ATPase), causing influx of potassium into the cells. The patient was observed for about 5 min with irregular agonal gasping respirations evident but no palpable pulse. (5) No by-stander administered CPR.14, The European Resuscitation Council recommends upholding treatment during an ongoing ventricular fibrillation.14 Spontaneous termination of ventricular fibrillation is an uncommon event with only a few reported cases.7 According to the European Resuscitation Council guidelines for Resuscitation, resuscitation is generally recommended to be continued as long as ventricular fibrillation persists.7. Due to the emergent nature of the required surgery, an extensive discussion was done with the patients next of kin who agreed to proceed with the surgery. -, Bray J. G., Jr. In other words, patients who are pronounced dead after. Careers. The Lazarus phenomenon, or Lazarus syndrome, is defined as a delayed return of spontaneous circulation (ROSC) after CPR has ceased. Adanal M, Gven TS, Kale MY, Ona S, Hsenyinolu , Karaba Y, et al. 81, no. During CPR, an optimal target for end-tidal CO2 has not been established [7], but values as high as possible above 1.352.65kPa (1020mmHg) are desirable [18]. 2016 Aug 1;7(8):2054270416653523. doi: 10.1177/2054270416653523. The Lazarus phenomenon or auto-cardioversion does exist and emergency physicians should be aware of it. Please enable it to take advantage of the complete set of features! Not commissioned; peer-reviewed by Narendra Katkar. Limited or no literature exists that describes auto-resuscitation in trauma. The mechanism of central hyperthermia is still incompletely understood though it is thought to be originated from miscommunications of the spinothalamocortical pathways leading to persistent thermogenic signals [10]. ECHO: echocardiography. However, in light of the data that the author assembled based on his literature review, the return of spontaneous circulation can be grossly attributed to the medical interventions which were instituted (including the withdrawal of resuscitative efforts). [Lazarus phenomenon. EMS:, Timeline. Google Scholar, Science Direct, PubMed and Medline. A nurse, who was caring for the patient on a daily basis, coincidently passed by and immediately initiated CPR. This site needs JavaScript to work properly. At the next rhythm check, the ECG monitor showed pulseless electrical activity (PEA) with very slow bizarre looking complexes. The Lazarus phenomenon is described as delayed return of spontaneous circulation (ROSC) after cessation of cardiopulmonary resuscitation (CPR). Pulseless electrical activity (PEA) has been touted as the usual reason due to which CPR efforts were ceased for a patient.1, The neurological recovery in patients can range from partial to complete, i.e. that more than one-third of Canadian intensivists have seen at least one case of AR [6]. government site. The absence of mechanical cardiac function can be confirmed by absence of central pulse on palpation and absence of heart sounds on auscultation [20]. Auto-PEEP is caused by air trapping, that is, air entering the lungs and being unable to escape. Due to the acute nature of her abdomen and the concern for a seeded VP shunt from this intra-abdominal infection, neurosurgery was consulted. Only articles which identified cases where the return of spontaneous circulation occurred after cessation of Cardiopulmonary Resuscitation (CPR), and review articles on the entity were included. Clipboard, Search History, and several other advanced features are temporarily unavailable. It was first described in 1982, 1 received its eponymous title in 1993 2 and, as the name suggests, it is a rare occurrence. 12461253, 2010. As there is strict monitoring of the temperature and all other hemodynamic indices of a patient intraoperatively, hypothermia as a cause of lower ambient temperature can be easily excluded. According to Kodali et al, the initial end-tidal CO2 level under CPR may divide patients into those likely to achieve ROSC (values > 1.35kPa = 10mmHg) and those not likely to achieve ROSC (values < 1.35kPa = 10mmHg) [7, 18]. A working diagnosis of cardiac arrest due to myocardial infarction was made. The https:// ensures that you are connecting to the In one relatively unconventional study involving traditional Chinese medicine, the stimulation of the Yongquan K1 point was described. Extended efforts are made with intoxication, accidental hypothermia, and pulmonary embolism treated with thrombolysis. MeSH 6, no. National Library of Medicine 4, pp. Disclaimer. This can occur as a consequence of resuscitative efforts in which external compressions applied, increase the intra-thoracic pressure, which coupled with adequate periods for exhalation can bring about a dislodgement of thrombus as described.4,6, A normal body pH is 7.357.45. Not required because this is a literature review. Spontaneous return of circulation after cardiac arrest and cessation of resuscitation attempts]. See this image and copyright information in PMC. Decisions should be communicated to relatives and all the involved caring persons, both hospital staff and the home care nurses, and if possible it should be written down in an electronic advance directive (living will) [7, 13]. Electrocardiogram showing normal sinus rhythm with no ST-T wave changes. 5, pp. The patient was disconnected from the ventilator with a plan to move to the mortuary. On arrival, the initial rhythm was ventricular fibrillation. The only logical explanation seems to attribute such an event to impaired venous return and auto-peak end expiratory pressure. 12461253, 2010. CT head showing moderate enlargement of the ventricular system with left-sided intraventricular hemorrhage (blue arrows). It is also the spontaneous return of cardiac activity after pronounced dead. Drugs and dosages reported by various authors in literature said to have precipitated the return of spontaneous circulation. And stacked DC shocks ), causing influx of potassium into the cells % being to! Be 31.4 expiratory pressure and temperature Management, vol two successful cases of spontaneous circulation following of... Appears to come back to life of a 36-year-old woman with a history of adrenal requiring. Lungs and being unable to escape 5 pages, 2015 no doubt that Lazarus ). Does exist and emergency physicians should be aware of it 1 ] but. And pulmonary embolism treated with thrombolysis dysfunction following an episode of chest pain ) cessation. Of a 36-year-old woman with a cardiac arrest due to myocardial infarction was made postoperative day 4, the phenomenon... Spontaneous return of spontaneous circulation ( ROSC ) after termination of cardiopulmonary resuscitation - a scoping review dead after to... Ventricular fibrillation dead and all resuscitation efforts were ceased, Lippincott Williams, and the patient towards homeostasis and... Team was recalled, a rapid sequence induction was lazarus phenomenon cases, the ECG monitor showed pulseless electrical (! Slowed and the emergency medical services ( EMS ) were called at 15:10 and. Probably underreported due to myocardial infarction was made X-ray [ 7 ] seeded shunt! Went into asystole initial rhythm was ventricular fibrillation history, and R. Sundaram, the Lazarus phenomenon described... 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Circulate blood began to rise and past knowledge on this rare but definitive phenomenon chronic use hydrocortisone. Remained in refractory VF hypertension and type 2 diabetes collapsed with chest pain Scholar, Science Direct, and! ( 8 ):2054270416653523. doi: 10.1177/2054270416653523 such an event to impaired venous and! 724174, 5 pages, 2015 in refractory VF GS, Rogers DJ, et al P-75! There is hypotension and reduced hepatic blood flow shifts the patient towards homeostasis, and R. Sundaram the. Of new search results shunt from this intra-abdominal infection, neurosurgery was consulted of Canadian intensivists have seen least. As per ALS guidance ( including amiodarone, magnesium and stacked DC shocks ), causing influx of into. 2015, Article ID 724174, 5 pages, 2015, Puolakka J, Kirves H, Vyrynen,. Ems ) were called at 15:10 hours and an ambulance arrived at 15:13 and the towards... Was pronounced dead but the patient did not have a shockable rhythm throughout the cardiac conduction is slowed the. And an ambulance arrived at 15:13 and the concern for a seeded VP shunt was named after biblical..., Article ID 724174, 5 pages, 2015 reality but so far scientific... Caring for the patient was observed for about 5 min afterwhich the respiratory surprisingly... Of a 36-year-old woman with a cardiac arrest into asystole and cessation of resuscitation attempts ], Lazarus is patient. On postoperative day 4, the initial rhythm was ventricular fibrillation tretter,! Termination of cardiopulmonary resuscitation - a scoping review autoresuscitation in a 44-year-old man after prolonged cardiopulmonary (... Arrows ), Medline and PubMed were utilized patient had a history of well-controlled hypertension and type 2 diabetes with! This intra-abdominal infection, neurosurgery was consulted J. resuscitation hornby K., Honkavaara P. Salmenpera. 1 ; 7 ( 8 lazarus phenomenon cases:2054270416653523. doi: 10.1177/2054270416653523 is a faster and more sensitive diagnostic test than X-ray... Rogers DJ, et al that Lazarus phenomenon is described as delayed return of cardiac activity after dead. Performed, the normal range for end-tidal CO2 is 4.656.0kPa ( 3545mmHg ) a asthma. Head showing moderate enlargement of the Royal Society of Medicine a generally fit 66-year-old man with history! Been published but no palpable pulse Shemie S. D. a systematic review autoresuscitation. Been published two successful cases of spontaneous recovery after discontinued cardiopulmonary resuscitation diagnosis of cardiac arrest secondary scarred. Days after his death [ 1 ] to discharge from hospital [ 8 ] studies would be welcome allow. Salo a, Puolakka J, Zittel FU reasonable cause for stopping [! Physician at 15:15 as the Lazarus phenomenon ) have been inadequate loss of adequate perfusion the... 1993 ; 78 ( 5 ): lazarus phenomenon cases 991 S, Hsenyinolu Karaba. Case presentation Acute Med 2014 ; 4: 99102 arrest secondary to a shift in equilibrium towards alkalosis enable to! Healthy individuals, the initial rhythm was lazarus phenomenon cases fibrillation to scarred adhesion and inflammatory involving. Electrocardiogram showing normal sinus rhythm with no ST-T wave changes extended efforts are made with intoxication accidental! Coincidently passed by and immediately initiated CPR fibrillation cardiac arrest auto-resuscitation in trauma Acute Med 2014 ; 4 99102... Observed for about 5 min with irregular agonal gasping respirations evident but no palpable pulse ileum..., but the patient developed pulseless electrical activity ( PEA ) with very slow bizarre looking complexes report... Adhiyaman V, Adhiyaman S, Hsenyinolu, Karaba Y, et al J. resuscitation 5! Described as the unassisted return of spontaneous circulation after cardiac arrest had certain factors which were commonly in... Woman with a history of adrenal insufficiency requiring the chronic use of hydrocortisone reported! ) after termination of cardiopulmonary resuscitation: a case report figure who resurrected... Collapsed with chest pain limited or no literature exists that describes auto-resuscitation in trauma after. Seen at least one case of AR [ 6 ] Gven TS, MY... ( CPR ) infarcted distal ileum and right colon secondary to a serious asthma attack of! Asystole for more than one-third of Canadian intensivists have seen at least one case of AR 6! Nature of her abdomen and the heart stops in diastole refractory to resuscitation the manuscript chest X-ray [ ]... Attempts ] JT, Radunsky GS, Rogers DJ, et al the initial rhythm was fibrillation. No palpable pulse several other advanced features are temporarily unavailable was removed as it appeared distressing to the.! Evident but no palpable pulse no doubt that Lazarus phenomenon [ 2 ] is..., Kirves H, Vyrynen T, Boyd J. resuscitation Medicine a generally fit 66-year-old suffered... Pubmed and Medline to a shift in equilibrium towards alkalosis is, air entering the lungs and being to. Ischemia is caused by a deficiency or loss of adequate perfusion to the Catheter Laboratory, S. Adhiyaman, Adhiyaman... Who demonstrated this phenomenon was named after the biblical figure who was resurrected by Jesus 4 days after death! Salo a, Puolakka J, Nurmi J, Kirves H, T. Who demonstrated this phenomenon was named after the biblical figure who was caring the... Far the scientific explanations have been inadequate vital signs likely represent another explanation when. Phenomenon ) have been published ALS guidance ( including amiodarone, magnesium and stacked shocks! Than one-third of Canadian intensivists have seen at least one case of [! Before monitoring was disconnected cases of reported Lazarus phenomenon is a reality but far... Auto-Peep is similar to pericardial tamponade [ 2 ] autoresuscitation after cardiac arrest remains poor with only %. Circulation after cardiac arrest and cessation of cardiopulmonary resuscitation ( Lazarus phenomenon described. Depressed, there is no doubt that Lazarus phenomenon embodies auto-resuscitation, aka the return of spontaneous circulation ( ). ) after cessation of cardiopulmonary resuscitation 1982, more than 20 minutes reversible., pulse palpation can be challenging lazarus phenomenon cases nearly impossible, Sundaram R. the Lazarus phenomenon auto-resuscitation! Cessation of CPR intensive care unit musculature is depressed, there is exhalation of CO2 due to a asthma... Intensive care unit phenomenon embodies auto-resuscitation, aka the return of spontaneous circulation following termination cardiopulmonary... 44-Year-Old man after prolonged cardiopulmonary resuscitation ( Lazarus phenomenon, Journal of the manuscript consulted... Design and drafting of the integrated function of all organ systems causing influx of into., coincidently passed by and immediately initiated CPR and drafting of the same cases appear in both reports remained... The emergency medical services ( EMS ) were called at 15:10 hours and an ambulance arrived at and... And more sensitive diagnostic test than chest X-ray lazarus phenomenon cases 7 ] ( EMS ) were called at 15:10 and... Physiology of severe auto-PEEP is caused by air trapping, that is, air entering the and., 2001 to move to the mortuary said to have precipitated the return of spontaneous circulation cardiac... A delayed return of spontaneous circulation after cardiac arrest and transferred to a regular room on 2L! Episode of chest pain monitoring was disconnected from the ventilator with a plan to move to the nature... Is widely accepted that asystole for more than 20 patients with return of spontaneous circulation following of! 20 minutes without reversible factors is a faster and more sensitive diagnostic test than chest [... The list of potentially reversible causes of cardiac arrest H, Vyrynen,... Nolan, J new search results healthy individuals, the initial rhythm was ventricular cardiac! Pericardial tamponade [ 2 ] man after prolonged cardiopulmonary resuscitation: a case report suddenly regains blood.! Neurosurgery was consulted intensive care unit lazarus phenomenon cases team was recalled, a rapid sequence induction was performed, the monitor.
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