Cargando…

Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review

BACKGROUND: Autoresuscitation describes the return of spontaneous circulation after termination of resuscitation (TOR) following cardiac arrest (CA). We aimed to identify phenomena that may lead to autoresuscitation and to provide guidance to reduce the likelihood of it occurring. MATERIALS AND METH...

Descripción completa

Detalles Bibliográficos
Autores principales: Gordon, Les, Pasquier, Mathieu, Brugger, Hermann, Paal, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045737/
https://www.ncbi.nlm.nih.gov/pubmed/32102671
http://dx.doi.org/10.1186/s13049-019-0685-4
_version_ 1783501836596019200
author Gordon, Les
Pasquier, Mathieu
Brugger, Hermann
Paal, Peter
author_facet Gordon, Les
Pasquier, Mathieu
Brugger, Hermann
Paal, Peter
author_sort Gordon, Les
collection PubMed
description BACKGROUND: Autoresuscitation describes the return of spontaneous circulation after termination of resuscitation (TOR) following cardiac arrest (CA). We aimed to identify phenomena that may lead to autoresuscitation and to provide guidance to reduce the likelihood of it occurring. MATERIALS AND METHODS: We conducted a literature search (Google Scholar, MEDLINE, PubMed) and a scoping review according to PRISMA-ScR guidelines of autoresuscitation cases where patients undergoing CPR recovered circulation spontaneously after TOR with the following criteria: 1) CA from any cause; 2) CPR for any length of time; 3) A point was reached when it was felt that the patient had died; 4) Staff declared the patient dead and stood back. No further interventions took place; 5) Later, vital signs were observed. 6) Vital signs were sustained for more than a few seconds, such that staff had to resume active care. RESULTS: Sixty-five patients with ROSC after TOR were identified in 53 articles (1982–2018), 18 (28%) made a full recovery. CONCLUSIONS: Almost a third made a full recovery after autoresuscitation. The following reasons for and recommendations to avoid autoresuscitation can be proposed: 1) In asystole with no reversible causes, resuscitation efforts should be continued for at least 20 min; 2) CPR should not be abandoned immediately after unsuccessful defibrillation, as transient asystole can occur after defibrillation; 3) Excessive ventilation during CPR may cause hyperinflation and should be avoided; 4) In refractory CA, resuscitation should not be terminated in the presence of any potentially-treatable cardiac rhythm; 5) After TOR, the casualty should be observed continuously and ECG monitored for at least 10 min.
format Online
Article
Text
id pubmed-7045737
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-70457372020-03-03 Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review Gordon, Les Pasquier, Mathieu Brugger, Hermann Paal, Peter Scand J Trauma Resusc Emerg Med Review BACKGROUND: Autoresuscitation describes the return of spontaneous circulation after termination of resuscitation (TOR) following cardiac arrest (CA). We aimed to identify phenomena that may lead to autoresuscitation and to provide guidance to reduce the likelihood of it occurring. MATERIALS AND METHODS: We conducted a literature search (Google Scholar, MEDLINE, PubMed) and a scoping review according to PRISMA-ScR guidelines of autoresuscitation cases where patients undergoing CPR recovered circulation spontaneously after TOR with the following criteria: 1) CA from any cause; 2) CPR for any length of time; 3) A point was reached when it was felt that the patient had died; 4) Staff declared the patient dead and stood back. No further interventions took place; 5) Later, vital signs were observed. 6) Vital signs were sustained for more than a few seconds, such that staff had to resume active care. RESULTS: Sixty-five patients with ROSC after TOR were identified in 53 articles (1982–2018), 18 (28%) made a full recovery. CONCLUSIONS: Almost a third made a full recovery after autoresuscitation. The following reasons for and recommendations to avoid autoresuscitation can be proposed: 1) In asystole with no reversible causes, resuscitation efforts should be continued for at least 20 min; 2) CPR should not be abandoned immediately after unsuccessful defibrillation, as transient asystole can occur after defibrillation; 3) Excessive ventilation during CPR may cause hyperinflation and should be avoided; 4) In refractory CA, resuscitation should not be terminated in the presence of any potentially-treatable cardiac rhythm; 5) After TOR, the casualty should be observed continuously and ECG monitored for at least 10 min. BioMed Central 2020-02-26 /pmc/articles/PMC7045737/ /pubmed/32102671 http://dx.doi.org/10.1186/s13049-019-0685-4 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Gordon, Les
Pasquier, Mathieu
Brugger, Hermann
Paal, Peter
Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review
title Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review
title_full Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review
title_fullStr Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review
title_full_unstemmed Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review
title_short Autoresuscitation (Lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review
title_sort autoresuscitation (lazarus phenomenon) after termination of cardiopulmonary resuscitation - a scoping review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045737/
https://www.ncbi.nlm.nih.gov/pubmed/32102671
http://dx.doi.org/10.1186/s13049-019-0685-4
work_keys_str_mv AT gordonles autoresuscitationlazarusphenomenonafterterminationofcardiopulmonaryresuscitationascopingreview
AT pasquiermathieu autoresuscitationlazarusphenomenonafterterminationofcardiopulmonaryresuscitationascopingreview
AT bruggerhermann autoresuscitationlazarusphenomenonafterterminationofcardiopulmonaryresuscitationascopingreview
AT paalpeter autoresuscitationlazarusphenomenonafterterminationofcardiopulmonaryresuscitationascopingreview