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- The Lazarus effect (autoresuscitation) is when someone declared dead from cardiac arrest suddenly shows signs of life, usually within 10 minutes of CPR ending. This makes it seem like they’ve come back to life, but in fact they hadn’t died. This is a rare phenomenon, and healthcare providers don’t know the exact cause. What is the Lazarus effect?
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What is the Lazarus Effect?
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Apr 4, 2023 · The Lazarus effect (autoresuscitation) is when someone declared dead from cardiac arrest suddenly shows signs of life, usually within 10 minutes of CPR ending. This makes it seem like they’ve come back to life, but in fact they hadn’t died. This is a rare phenomenon, and healthcare providers don’t know the exact cause.
- Overview
- What is Lazarus syndrome?
- What might cause Lazarus syndrome?
- Mistaking the living for the dead
- Hypothermia, catalepsy, and locked-in syndrome
- Confirming death beyond doubt
Her heart had stopped beating and she was no longer breathing. Janina Kolkiewicz was declared dead. At 91 years old, she had lived a long life. But she was not about to stop living it. Eleven hours later, she awoke in the hospital mortuary with a craving for tea and pancakes. As inconceivable as it sounds, Kolkiewicz is just one of many people said to have “risen from the dead.”
In 2001, a 66-year-old man experienced cardiac arrest while undergoing surgery for an abdominal aneurysm.
After 17 minutes of resuscitation efforts – incorporating CPR, defibrillation, and medication – the man’s vital signs failed to return, and he was pronounced dead. Ten minutes later, his surgeon felt a pulse. He was alive. The man’s operation continued, with a successful outcome.
In 2014, a 78-year-old man from Mississippi was declared dead after a hospice nurse found him with no pulse. The next day, he woke up in a body bag at the morgue.
The Lazarus phenomenon, or Lazarus syndrome, is defined as a delayed return of spontaneous circulation (ROSC) after CPR has ceased. In other words, patients who are pronounced dead after cardiac arrest experience an impromptu return of cardiac activity.
The syndrome is named after Lazarus of Bethany, who – according to the New Testament of the Bible – was brought back to life by Jesus Christ 4 days after his death.
Since 1982, when the Lazarus phenomenon was first described in medical literature, there have been at least 38 reported cases.
According to a 2007 report by Vedamurthy Adhiyaman and colleagues, in around 82 percent of Lazarus syndrome cases to date, ROSC occurred within 10 minutes of CPR being stopped, and around 45 percent of patients experienced good neurological recovery.
But while the low number of report cases might highlight the rarity of Lazarus syndrome, scientists believe that it is much more common than studies suggest.
“The Lazarus phenomenon is a grossly underreported event,” notes Maxillofacial Surgeon Dr. Vaibhav Sahni in a 2016 report.
Some researchers suggest that the Lazarus phenomenon may be down to a pressure buildup in the chest caused by CPR. Once CPR is ceased, this pressure may gradually release and kick-start the heart back into action.
Another theory is the delayed action of medication used as a part of resuscitation efforts, such as adrenaline.
“It is possible that drugs injected through a peripheral vein are inadequately delivered centrally due to impaired venous return, and when venous return improves after stopping the dynamic hyperinflation, delivery of drugs could contribute to return of circulation,” explain Adhiyaman and colleagues.
Hyperkalemia – whereby blood levels of potassium are too high – is another proposed explanation for the Lazarus phenomenon, as it has been linked to delayed ROSC.
Because so few cases of Lazarus syndrome are reported, uncovering the exact mechanisms behind the condition is tricky.
But perhaps it is not what is bringing a patient back to life that we should be concerned about; maybe they were never deceased.
As Benjamin Franklin once said, “In this world nothing is certain but death and taxes.” In a clinical setting, however, a declaration of death is not as certain as one might think.
In 2014 came a report of an 80-year-old woman who had been “frozen alive” in a hospital morgue after being wrongly pronounced dead.
In the same year, a New York Hospital came under fire after incorrectly declaring a woman as brain dead following a drug overdose. The woman awoke shortly after being taken to the operating room for organ harvesting.
Cases such as these beg the question, how is it even possible to mistakingly declare a person as dead?
There are two types of death: clinical death and biological death. Clinical death is defined as the absence of a pulse, heartbeat, and breathing, while biological death is defined as the absence of brain activity.
Looking at these definitions, you might assume that it would be easy to tell when a person is deceased – but in some cases, it is not so simple.
One such condition is hypothermia, whereby the body experiences a sudden, potentially fatal drop in temperature, normally caused by prolonged exposure to the cold.
Hypothermia can cause heartbeat and breathing to slow, to the point where it is almost undetectable. It is believed that hypothermia led to the mistaken death of a newborn baby in Canada in 2013.
The baby in question was born on a sidewalk in freezing cold temperatures. Doctors were unable to detect a pulse, and the baby was declared dead. Two hours later, the baby started moving.
Dr. Michael Klein, of the University of British Columbia in Canada, said that the baby’s exposure to such cold temperatures may explain the situation. “The whole circulation would have stopped but the neurological condition of the child could be protected by the cold.”
Catalepsy and locked-in syndrome are examples of other conditions in which the living could be mistaken for dead.
Catalepsy is characterized by a trance-like state, slowed breathing, reduced sensitivity, and complete immobility, which can last from minutes to weeks. The condition may arise as a symptom of neurological disorders such as epilepsy and Parkinson’s disease.
If this article has sent a shiver down your spine, fear not; Lazarus syndrome is extremely rare, as is the possibility of being wrongly declared as deceased.
That said, the fact that such cases have even occurred has raised questions about death recognition and confirmation in a clinical setting.
According to Adhiyaman and colleagues, some researchers have suggested that patients should be “passively monitored” for 10 minutes following death, as that is the time frame in which delayed ROSC is most likely to occur.
“Death should not be certified in any patient immediately after stopping CPR,” the researchers write, “and one should wait at least 10 minutes, if not longer, to verify and confirm death beyond doubt.”
When it comes to organ donation, however, other researchers note that waiting as long as 10 minutes to see whether ROSC might occur could be detrimental.
Current guidelines recommend 2 to 5 minutes of observation after the heart has stopped beating before declaring death; the longer the blood flow to the organs is restricted, the less likely they are to be suitable for donation.
Vascular specialists, who work with patients experiencing conditions and disorders of the blood vessels, often talk of the “Lazarus effect,” a phenomenon in which a patient revives after coming to the brink of death, as happens in stroke or heart failure.
Jul 26, 2021 · The Lazarus phenomenon is a rare, possibly under-reported condition that happens when someone who seems to be dead shows signs of life again, typically several minutes after health workers stop ...
- Evan Starkman
Mar 2, 2015 · Culture. The Lazarus Effect 's Empathetic Brand of Resurrection Horror. The low-budget, science-experiment-gone-wrong film explores the nightmare of coming back to life from the perspective of...
- Lenika Cruz
In the words of one oncologist interviewed in the study, “It’s pretty emotional, it’s pretty intense in the room. You can kind of feel the heaviness, and it almost feels like every time you do this, a ton of bricks has fallen on top of you, if you let yourself go there” ( Bluhm et al. 2016, e1011).
The Lazarus sign or Lazarus reflex is a reflex movement in brain-dead or brainstem failure patients, [1] which causes them to briefly raise their arms and drop them crossed on their chests (in a position similar to some Egyptian mummies ).
