Return of spontaneous circulation after cessation of cardiopulmonary resuscitation in a case of digoxin overdosage

Al-Ansari, Mariam; Abouchaleh, Nabil; Hijazi, Mohammed

doi:10.1080/09563070500193092

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…So far 38 cases of delayed ROSC have been published in the medical literature. 1–28 The majority of the articles appeared in the anaesthetic and intensive care journals. Cases described include both in-hospital and out-of-hospital arrests.…”

Section: Methodsmentioning

confidence: 99%

The Lazarus phenomenon

Adhiyaman

Adhiyaman²,

Sundaram

2007

J R Soc Med

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Even though Lazarus phenomenon is rare, it is probably under reported. There is no doubt that Lazarus phenomenon is a reality but so far the scientific explanations have been inadequate. So far the only plausible explanation at least in some cases is auto-PEEP and impaired venous return. In patients with PEA or asystole, dynamic hyperinflation should considered as a cause and a short period of apnoea (30-60 seconds) should be tried before stopping resuscitation. Since ROSC occurred within 10 minutes in most cases, patients should be passively monitored for at least 10 minutes after the cessation of CPR before confirming death.

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Section: Methodsmentioning

confidence: 99%

The Lazarus phenomenon

Adhiyaman

Adhiyaman²,

Sundaram

2007

J R Soc Med

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Donation after cardiocirculatory death: a call for a moratorium pending full public disclosure and fully informed consent

Joffe

Carcillo

Anton

et al. 2011

Philos Ethics Humanit Med

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Many believe that the ethical problems of donation after cardiocirculatory death (DCD) have been "worked out" and that it is unclear why DCD should be resisted. In this paper we will argue that DCD donors may not yet be dead, and therefore that organ donation during DCD may violate the dead donor rule. We first present a description of the process of DCD and the standard ethical rationale for the practice. We then present our concerns with DCD, including the following: irreversibility of absent circulation has not occurred and the many attempts to claim it has have all failed; conflicts of interest at all steps in the DCD process, including the decision to withdraw life support before DCD, are simply unavoidable; potentially harmful premortem interventions to preserve organ utility are not justifiable, even with the help of the principle of double effect; claims that DCD conforms with the intent of the law and current accepted medical standards are misleading and inaccurate; and consensus statements by respected medical groups do not change these arguments due to their low quality including being plagued by conflict of interest. Moreover, some arguments in favor of DCD, while likely true, are "straw-man arguments," such as the great benefit of organ donation. The truth is that honesty and trustworthiness require that we face these problems instead of avoiding them. We believe that DCD is not ethically allowable because it abandons the dead donor rule, has unavoidable conflicts of interests, and implements premortem interventions which can hasten death. These important points have not been, but need to be fully disclosed to the public and incorporated into fully informed consent. These are tall orders, and require open public debate. Until this debate occurs, we call for a moratorium on the practice of DCD.

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

Gordon

Pasquier

Brugger

et al. 2020

Scand J Trauma Resusc Emerg Med

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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.

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Return of spontaneous circulation after cessation of cardiopulmonary resuscitation in a case of digoxin overdosage

Cited by 3 publications

References 13 publications

The Lazarus phenomenon

The Lazarus phenomenon

Donation after cardiocirculatory death: a call for a moratorium pending full public disclosure and fully informed consent

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

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