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

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

doi:10.3109/09563070500193092

Cited by 5 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are many cases of autoresuscitation described in the literature, and some have indeed been hampered by inadequate monitoring [ 24 ]. Some cases have had constant EKG monitoring with constant observation; 6 of these had autoresuscitation at 5–8 minutes after absent circulation and asystole (implying also absent brain blood flow) (Table 1 ) [ 25 - 30 ]. Some cases have had arterial line monitoring in addition to continuous EKG and observation, with 3 of these having autoresuscitation at 3–5 minutes after absent circulation and asystole (Table 1 ) [ 31 - 33 ].…”

Section: Discussionmentioning

confidence: 99%

The ethics of donation and transplantation: are definitions of death being distorted for organ transplantation?

Joffe

2007

Philos Ethics Humanit Med

View full text Add to dashboard Cite

A recent commentary defends 1) the concept of 'brain arrest' to explain what brain death is, and 2) the concept that death occurs at 2-5 minutes after absent circulation. I suggest that both these claims are flawed. Brain arrest is said to threaten life, and lead to death by causing a secondary respiratory then cardiac arrest. It is further claimed that ventilation only interrupts this way that brain arrest leads to death. These statements imply that brain arrest is not death itself. Brain death is a devastating state that leads to death when intensive care, which replaces some of the brain's vital functions such as breathing, is withdrawn and circulation stops resulting in irreversible loss of integration of the organism. Circulatory death is said to occur at 2-5 minutes after absent circulation because, in the context of DCD, the intent is to not attempt reversal of the absent circulation. No defense of this weak construal of irreversible loss of circulation is given. This means that patients in identical physiologic states are dead (in the DCD context) or alive (in the resuscitation context); the current state of death (at 2-5 minutes) is contingent on a future event (whether there will be resuscitation) suggesting backward causation; and the commonly used meaning of irreversible as 'not capable of being reversed' is abandoned. The literature supporting the claim that autoresuscitation does not occur in the context of no cardiopulmonary resuscitation is shown to be very limited. Several cases of autoresuscitation are summarized, suggesting that the claim that these cases are not applicable to the current debate may be premature. I suggest that brain dead and DCD donors are not dead; whether organs can be harvested before death from these patients whose prognosis is death should be debated urgently.

show abstract

Section: Discussionmentioning

confidence: 99%

The ethics of donation and transplantation: are definitions of death being distorted for organ transplantation?

Joffe

2007

Philos Ethics Humanit Med

View full text Add to dashboard Cite

show abstract

“…Die Entscheidung, Reanimationsmaßnahmen zu beenden, sollte immer im Team getroffen werden [29,64,66]. Hierbei müssen u. a. die Faktoren Patientenwille, Vorerkrankungen, Prognose, Reanimationsdauer und primärer Rhythmus einbezogen werden [4,5,6,7,13,15,16,17,18,26,37,38,43,45,52,55,58,68]. Bezüglich der Prognose und möglichen Therapieentscheidung nach einem stattgehabten Lazarus-Phänomen ist von Bedeutung, wie lange der Kreislaufstillstand bis zum SROC Bestand hatte [44].…”

Section: Ethische Und Juristische Aspekteunclassified

Lazarus-Phänomen

et al. 2010

View full text Add to dashboard Cite

In the relevant medical literature, the Lazarus phenomenon is a rare occurrence. It seems to be a phenomenon which has often been described in non-medical literature but not published in medical literature. The pathophysiological mechanisms are poorly understood. In the literature several mechanisms are discussed which could be important for this phenomenon, e.g. autopositive end-expiratory pressure, hyperventilation and alkalosis, hyperkalemia, delayed action of drugs and unobserved minimal vital signs. In the literature it is recommended that patients should be passively monitored for at least 10 min after cessation of resuscitation. However, more scientific experimental investigations seem to be necessary to gain a better understanding of this phenomenon.

show abstract

A systematic review of autoresuscitation after cardiac arrest*

Hornby

Shemie

2010

Critical Care Medicine

158

104

View full text Add to dashboard Cite

These findings suggest that the provision of cardiopulmonary resuscitation may influence autoresuscitation. In the absence of cardiopulmonary resuscitation, as may apply to controlled organ donation after cardiac death after withdrawal of life-sustaining therapies, autoresuscitation has not been reported. The provision of cardiopulmonary resuscitation, as may apply to uncontrolled organ donation after cardiac death, may influence observation time. However, existing evidence is limited and is consequently insufficient to support or refute the recommended waiting period to determine death after a cardiac arrest, strongly supporting the need for prospective studies in dying patients.

show abstract

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

Cited by 5 publications

References 5 publications

The ethics of donation and transplantation: are definitions of death being distorted for organ transplantation?

The ethics of donation and transplantation: are definitions of death being distorted for organ transplantation?

Lazarus-Phänomen

A systematic review of autoresuscitation after cardiac arrest*

Contact Info

Product

Resources

About