From the Guidelines
The Lazarus phenomenon refers to the rare phenomenon of spontaneous return of circulation after cardiac arrest, as noted in the context of cardiopulmonary resuscitation and emergency cardiovascular care science 1. The term is derived from the biblical story of Lazarus, who was raised from the dead. In medical literature, this phenomenon is often described in the context of cardiac arrest outcomes and psychological well-being after cardiac arrest.
- Key aspects of the Lazarus phenomenon include:
- Spontaneous return of circulation after cardiac arrest
- Association with witnessed consciousness and cardiac arrest outcomes
- Consideration of rescuer outcomes and psychological well-being after cardiac arrest According to the 2021 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science, the Lazarus phenomenon is a recognized concept, although it is not fully understood and requires further research 1.
- The study by Wyckoff et al. in 2021 provides an overview of the current understanding of the Lazarus phenomenon, including its association with cardiac arrest outcomes and psychological well-being after cardiac arrest 1. It is essential to note that the Lazarus phenomenon is a rare event, and its occurrence is often unpredictable. Therefore, it is crucial to prioritize high-quality cardiopulmonary resuscitation and emergency cardiovascular care to minimize the risk of cardiac arrest and optimize outcomes 1.
From the Research
Definition and Explanation
- The Lazarus phenomenon is a rare condition where a patient experiences a delayed return of spontaneous circulation (ROSC) after the cessation of cardiopulmonary resuscitation (CPR) 2, 3, 4, 5, 6.
- It is also known as autoresuscitation or the "Lazarus phenomenon" 6.
- The pathophysiological explanation for this phenomenon is still inadequate, but possible causes include auto-PEEP and impaired venous return 2.
Clinical Presentation and Management
- The Lazarus phenomenon can occur in patients with various underlying conditions, including cardiac arrest, myocardial infarction, and septic shock 3, 4, 5.
- In some cases, patients may show signs of recovery after a period of apnoea, highlighting the importance of careful observation and monitoring after CPR cessation 2, 4.
- The phenomenon can be underreported, and healthcare professionals should be aware of its possibility to provide appropriate medical care 2, 3, 4, 5, 6.
Implications and Recommendations
- The Lazarus phenomenon has significant implications for the determination of death and the cessation of CPR 2, 3, 4, 5, 6.
- Patients should be passively monitored for at least 10 minutes after CPR cessation before confirming death 2.
- Healthcare professionals should approach the interruption of CPR with caution, especially in cases of acute myocardial infarction or COVID-19 infection 3, 5.