Lazarus syndrome-a miraculous revival
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20241519Keywords:
Autoresuscitation, Lazarus syndrome, Historical roots, ROSC, CPRAbstract
The Lazarus syndrome, named after the biblical account of Lazarus, being raised from the dead, refers to the uncommon occurrence of spontaneous recovery of circulation following failed resuscitation attempts. This review article delves into the historical foundations, underlying mechanisms, prominent instances, disputes, ethical concerns, medical interventions, and psychological consequences of Lazarus syndrome. Despite being recorded in medical literature, the mechanisms underlying this condition are not well known. Possible explanations include medication-related delays, hyperkalemia, reperfusion damage, myocardial shock, and brainstem reflexes. While Lazarus syndrome calls into question our notion of life and death, it also raises ethical concerns about death verification, informed consent, quality of life, resource allocation, and cultural values therapies include diagnosing underlying reasons, enhanced cardiac life support, extracorporeal membrane oxygenation, therapeutic hypothermia, and ongoing monitoring. The psychological burden on healthcare staff and families is significant, necessitating assistance and coping measures. Understanding and managing the intricacies of Lazarus syndrome is critical to the well-being of everyone concerned.
References
Adhiyaman V, Adhiyaman S, Sundaram R. The Lazarus phenomenon. J R Soc Med. 2007;100(12):552-57.
Linko K, Honkavaara P, Salmenpera M. Recovery after discontinued cardiopulmonary resuscitation. Lancet. 1982;319(8263):106-7.
Ding WY, Meah M, Mann P. Unassisted return of spontaneous circulation after ventricular fibrillation. J Cardiovasc Electrophysiol. 2018;29(1):199-200.
Hannig KE, Hauritz RW, Grove EL. Autoresuscitation: A Case and Discussion of the Lazarus Phenomenon. Case Rep Med. 2015;2015:724174.
Hornby K, Hornby L, Shemie SD. A systematic review of autoresuscitation after cardiac arrest. Crit Care Med. 2010;38(5):1246-53.
Gordon L, Pasquier M, Brugger H, Paal P. Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation-a scoping review. Scand J Trauma Resusc Emerg Med. 2020;28(1):14.
Pappano AJ, Gil Wier W. Coronary Circulation. In: Cardiovascular Physiology. Elsevier. 2013;223-6.
Benghanem S, Mazeraud A, Azabou E, Chhor V, Shinotsuka CR, Claassen J, et al. Brainstem dysfunction in critically ill patients. Crit Care. 2020;24(1):5.
Sprenkeler DJ, van Hout GPJ, Chamuleau SAJ. Lazarus in asystole: a case report of autoresuscitation after prolonged cardiac arrest. de Potter T, Iliodromitis K, Duplyakov D, Aziz A, Green P, eds. Eur Hear J Case Rep. 2019;3(3):ytz123.
Sharma M, Chandna M, Nguyen T, Vakil A, Franco Jr R, Ratnani I, et al. When a Dead Patient Is Not Really Dead: Lazarus Phenomenon. Case Reports Crit Care. 2020;2020:1-4.
Tretter JT, Radunsky GS, Rogers DJ, Daugherty LE. A Pediatric Case of Autoresuscitation. Pediatr Emerg Care. 2015;31(2):138-9.
Rzeźniczek P, Gaczkowska AD, Kluzik A, Cybulski M, Bartkowska-Śniatkowska A, Grześkowiak M. Lazarus Phenomenon or the Return from the Afterlife-What We Know about Auto Resuscitation. J Clin Med. 2023;12(14):4707.
Sukhyanti K, ShriKrishan C, Anu K, Ashish D. Lazarus phenomenon revisited: a case of delayed return of spontaneous circulation after carbon dioxide embolism under laparoscopic cholecystectomy. Anaesthesia Pain Intensive Care. 2019;20(3):338-40.
Güven AT, Petridis G, Özkal ŞŞ, Kalfoglu EA. Adli Tıbbi Açıdan Lazarus Fenomeni: Bir Olgu Sunumu. Bull Leg Med. 2017;22(3):224-7.
Ding WY, Meah M, Mann P. Unassisted return of spontaneous circulation after ventricular fibrillation. J Cardiovasc Electrophysiol. 2018;29(1):199-200.
Mullen S, Roberts Z, Tuthill D, Owens L, Te Water Naude J, Maguire S. Lazarus Syndrome - Challenges Created by Pediatric Autoresuscitation. Pediatr Emerg Care. 2021;37(4):e210-11.
Sprenkeler DJ, van Hout GPJ, Chamuleau SAJ. Lazarus in asystole: a case report of autoresuscitation after prolonged cardiac arrest. Eur Hear J Case Rep. 2019;3(3):ytz134.
Sharma M, Chandna M, Nguyen T, Vakil A, Franco Jr R, Ratnani I, et al. When a Dead Patient Is Not Really Dead: Lazarus Phenomenon. Case reports Crit care. 2020;2020:8841983.
Martinez-Ávila MC, Almanza Hurtado A, Trespalacios Sierra A, Rodriguez Yanez T, Dueñas-Castell C. Lazarus Phenomenon: Return of Spontaneous Circulation After Cessation of Prolonged Cardiopulmonary Resuscitation in a Patient With COVID-19. Cureus. 2021;13(8):e17089.
Meeker JW, Kelkar AH, Loc BL, Lynch TJ. A Case Report of Delayed Return of Spontaneous Circulation: Lazarus Phenomenon. Am J Med. 2016;129(12):e343-4.
Zorko DJ, Shemie J, Hornby L, Singh G, Matheson S, Sandarage R, et al. Autoresuscitation after circulatory arrest: an updated systematic review. Can J Anaesth. 2023;70(4):699-712.
Gaba WH, El Hag SA, Bashir SM. Risen Alive: The Lazarus Phenomenon. Case reports Crit care. 2022;2022:3322056.
Steinhorn D, Calligan AL. Lazarus Syndrome in Pediatric Hospice Care: Does It Occur and What Home Hospice Providers Should Know? In: Section on Hospice and Palliative Medicine Program. Am Academy Pediatr. 2021;538-9.
Tiesmeier J, Brandt O, Emmerich M. Unexpected return of vital signs after cessation of prehospital resuscitation--Lazarus phenomenon. MMW Fortschr Med. 2010;152(23):33-6.
Martinez-Ávila MC, Almanza Hurtado A, Trespalacios Sierra A, Rodriguez Yanez T, Dueñas-Castell C. Lazarus Phenomenon: Return of Spontaneous Circulation After Cessation of Prolonged Cardiopulmonary Resuscitation in a Patient With COVID-19. Cureus. 2021;13(8):e17089.
Kostka AM, Borodzicz A, Krzemińska SA. Feelings and Emotions of Nurses Related to Dying and Death of Patients-A Pilot Study. Psychol Res Behav Manag. 2021;705-17.
Houska A, Loučka M. Patients’ Autonomy at the End of Life: A Critical Review. J Pain Symptom Manage. 2019;57(4):835-45.
Duff JP, Joffe AR, Sevcik W, DeCaen A. Autoresuscitation after pediatric cardiac arrest: is hyperventilation a cause? Pediatr Emerg Care. 2011;27(3):208-9.
Gordon L, Pasquier M, Brugger H, Paal P. Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation-a scoping review. Scand J Trauma Resusc Emerg Med. 2020;28(1):14.
Mahon T, Kalakoti P, Conrad SA, Samra NS, Edens MA. Lazarus phenomenon in trauma. Trauma Case Rep. 2020;25:100280.
Zorko DJ, Shemie J, Hornby L, Singh G, Matheson S, Sandarage R, et al. Autoresuscitation after circulatory arrest: an updated systematic review. Can J Anesth Can d’anesthésie. 2023;70(4):699-712.
Kuisma M, Salo A, Puolakka J, Nurmi J, Kirves H, Väyrynen T, et al. Delayed return of spontaneous circulation (the Lazarus phenomenon) after cessation of out-of-hospital cardiopulmonary resuscitation. Resuscitation. 2017;118:107-11.
Rajajee V, Muehlschlegel S, Wartenberg KE, Alexander SA, Busl KM, Chou SHY, et al. Guidelines for Neuroprognostication in Comatose Adult Survivors of Cardiac Arrest. Neurocrit Care. 2023;38(3):533-63.
Mavrovounis G, Kontou M, Tsiotsikas O, Mermiri M, Tsolaki V, Beltsios E, et al. From flatline to lifeline: A scoping review of the Lazarus phenomenon. Am J Emerg Med. 2023;72:44-57.
Nolan JP, Soar J, Kane AD, Moppett IK, Armstrong RK, Kursumovic E, et al. Peri‐operative decisions about cardiopulmonary resuscitation among adults as reported to the 7th National Audit Project of the Royal College of Anaesthetists. Anaesthesia. 2024;79(2):186-92.
Silverplats J, Södersved Källestedt M-L, Äng B, Strömsöe A. Compliance with cardiopulmonary resuscitation guidelines in witnessed in-hospital cardiac arrest events and patient outcome on monitored versus non-monitored wards. Resuscitation. 2024;196:110125.