Lazarus syndrome
Encyclopedia
Lazarus syndrome or autoresuscitation after failed cardiopulmonary resuscitation
is the spontaneous return of circulation
after failed attempts at resuscitation. Its occurrence has been noted in medical literature at least 25 times since 1982. Also called Lazarus phenomenon, it takes its name from Lazarus
who, in the New Testament
account, was raised from the dead by Jesus
.
Occurrences of the syndrome are extremely rare and the causes are not well understood. One theory for the phenomenon is that a chief factor (though not the only one) is the buildup of pressure in the chest as a result of cardiopulmonary resuscitation (CPR). The relaxation of pressure after resuscitation efforts have ended is thought to allow the heart to expand, triggering the heart's electrical impulses
and restarting the heartbeat. Other possible factors are hyperkalemia
or high doses of epinephrine
.
to be alive and breathing. She sued the medical center where it happened for damages due to physical and neurological problems stemming from the event.
Another case is a 66-year-old man suffering from a suspected abdominal aneurysm
. During treatment for this condition, the patient suffered cardiac arrest
and received chest compression
s and defibrillation
shocks for 17 minutes. Vital signs did not return; the patient was declared dead and resuscitation efforts ended. Ten minutes later, the surgeon felt a pulse. The aneurysm was successfully treated and the patient fully recovered with no lasting physical or neurological problems.
A 27-year-old man in the UK went into cardiac arrest after overdosing on heroin and cocaine
. After 25 minutes of resuscitation efforts, the patient was verbally declared dead. About a minute after resuscitation ended, a nurse noticed a rhythm on the heart monitor and resuscitation was resumed. The patient recovered fully.
An 18-year-old woman in Missouri, USA, attempted suicide by overdosing on sleeping medication. Resuscitation was attempted, but failed, and she was declared dead. Seven minutes later, her heart started beating and she started breathing on her own again, though she was coma
tose. The woman regained consciousness 5 days later and was oblivious to what had happened.
A 45 year-old woman in Colombia was pronounced dead, as there were no vital signs showing she was alive. Later, a funeral worker noticed the woman moving and alerted his co-worker that the woman should go back to the hospital.
A 65-year old man in Malaysia came back to life two-and-a-half hours after doctors at a Penang hospital pronounced him dead. He died three weeks later.
and organ harvesting
may take place. One doctor wrote, "Perhaps it is a supreme hubris
on our part to presume that we can reliably distinguish the reversible from the irreversible, or the salvageable from the nonsalvageable."
Medical literature has recommended observation of a patient's vital signs for five to ten minutes after cessation of resuscitation before certifying death.
Cardiopulmonary resuscitation
Cardiopulmonary resuscitation is an emergency procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person in cardiac arrest. It is indicated in those who are unresponsive...
is the spontaneous return of circulation
Circulatory system
The circulatory system is an organ system that passes nutrients , gases, hormones, blood cells, etc...
after failed attempts at resuscitation. Its occurrence has been noted in medical literature at least 25 times since 1982. Also called Lazarus phenomenon, it takes its name from Lazarus
Lazarus of Bethany
Lazarus of Bethany, also known as Saint Lazarus or Lazarus of the Four Days, is the subject of a prominent miracle attributed to Jesus in the Gospel of John, in which Jesus restores him to life four days after his death...
who, in the New Testament
New Testament
The New Testament is the second major division of the Christian biblical canon, the first such division being the much longer Old Testament....
account, was raised from the dead by Jesus
Jesus
Jesus of Nazareth , commonly referred to as Jesus Christ or simply as Jesus or Christ, is the central figure of Christianity...
.
Occurrences of the syndrome are extremely rare and the causes are not well understood. One theory for the phenomenon is that a chief factor (though not the only one) is the buildup of pressure in the chest as a result of cardiopulmonary resuscitation (CPR). The relaxation of pressure after resuscitation efforts have ended is thought to allow the heart to expand, triggering the heart's electrical impulses
Sinus rhythm
In medicine, sinus rhythm is the normal beating of the heart, as measured by an electrocardiogram . It has certain generic features that serve as hallmarks for comparison with normal ECGs.- ECG structure :...
and restarting the heartbeat. Other possible factors are hyperkalemia
Hyperkalemia
Hyperkalemia refers to the condition in which the concentration of the electrolyte potassium in the blood is elevated...
or high doses of epinephrine
Epinephrine
Epinephrine is a hormone and a neurotransmitter. It increases heart rate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. In chemical terms, adrenaline is one of a group of monoamines called the catecholamines...
.
Cases
One example is a 61-year-old woman from Delaware, USA, who was given "multiple medicines and synchronized shocks", but never regained a pulse. She was declared dead but was discovered in the morgueMorgue
A morgue or mortuary is used for the storage of human corpses awaiting identification, or removal for autopsy or disposal by burial, cremation or otherwise...
to be alive and breathing. She sued the medical center where it happened for damages due to physical and neurological problems stemming from the event.
Another case is a 66-year-old man suffering from a suspected abdominal aneurysm
Aneurysm
An aneurysm or aneurism is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. Aneurysms can commonly occur in arteries at the base of the brain and an aortic aneurysm occurs in the main artery carrying blood from the left ventricle of the heart...
. During treatment for this condition, the patient suffered cardiac arrest
Cardiac arrest
Cardiac arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively...
and received chest compression
Cardiopulmonary resuscitation
Cardiopulmonary resuscitation is an emergency procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person in cardiac arrest. It is indicated in those who are unresponsive...
s and defibrillation
Defibrillation
Defibrillation is a common treatment for life-threatening cardiac arrhythmias, ventricular fibrillation and pulseless ventricular tachycardia. Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator...
shocks for 17 minutes. Vital signs did not return; the patient was declared dead and resuscitation efforts ended. Ten minutes later, the surgeon felt a pulse. The aneurysm was successfully treated and the patient fully recovered with no lasting physical or neurological problems.
A 27-year-old man in the UK went into cardiac arrest after overdosing on heroin and cocaine
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...
. After 25 minutes of resuscitation efforts, the patient was verbally declared dead. About a minute after resuscitation ended, a nurse noticed a rhythm on the heart monitor and resuscitation was resumed. The patient recovered fully.
An 18-year-old woman in Missouri, USA, attempted suicide by overdosing on sleeping medication. Resuscitation was attempted, but failed, and she was declared dead. Seven minutes later, her heart started beating and she started breathing on her own again, though she was coma
Coma
In medicine, a coma is a state of unconsciousness, lasting more than 6 hours in which a person cannot be awakened, fails to respond normally to painful stimuli, light or sound, lacks a normal sleep-wake cycle and does not initiate voluntary actions. A person in a state of coma is described as...
tose. The woman regained consciousness 5 days later and was oblivious to what had happened.
A 45 year-old woman in Colombia was pronounced dead, as there were no vital signs showing she was alive. Later, a funeral worker noticed the woman moving and alerted his co-worker that the woman should go back to the hospital.
A 65-year old man in Malaysia came back to life two-and-a-half hours after doctors at a Penang hospital pronounced him dead. He died three weeks later.
Implications
The Lazarus Syndrome raises ethical issues for doctors, who must determine when medical death has occurred, resuscitation efforts should end, and post-mortem procedures such as autopsiesAutopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...
and organ harvesting
Organ harvesting
Organ harvesting refers to the removal, preservation and use of human organs and tissue from the bodies of the recently deceased to be used in surgical transplants on the living...
may take place. One doctor wrote, "Perhaps it is a supreme hubris
Hubris
Hubris , also hybris, means extreme haughtiness, pride or arrogance. Hubris often indicates a loss of contact with reality and an overestimation of one's own competence or capabilities, especially when the person exhibiting it is in a position of power....
on our part to presume that we can reliably distinguish the reversible from the irreversible, or the salvageable from the nonsalvageable."
Medical literature has recommended observation of a patient's vital signs for five to ten minutes after cessation of resuscitation before certifying death.
See also
- Lazarus signLazarus signThe Lazarus sign or Lazarus reflex is a reflex movement in brain-dead or brainstem failure patients, which causes them to briefly raise their arms and drop them crossed on their chests ....
- Lazarus taxonLazarus taxonIn paleontology, a Lazarus taxon is a taxon that disappears from one or more periods of the fossil record, only to appear again later. The term refers to the account in the Gospel of John, in which Jesus raised Lazarus from the dead...
- Near-death experience
- Premature burialPremature burialPremature burial, also known as live burial, burial alive, or vivisepulture, means to be buried while still alive. Animals or humans may be buried alive accidentally or intentionally...
- Suspended animationSuspended animationSuspended animation is the slowing of life processes by external means without termination. Breathing, heartbeat, and other involuntary functions may still occur, but they can only be detected by artificial means. Extreme cold can be used to precipitate the slowing of an individual's functions; use...