4.5 Review

From flatline to lifeline: A scoping review of the Lazarus phenomenon

Journal

AMERICAN JOURNAL OF EMERGENCY MEDICINE
Volume 72, Issue -, Pages 44-57

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ajem.2023.07.017

Keywords

Autoresuscitation; Lazarus phenomenon; Cardiopulmonary resuscitation; CPR; Resuscitation

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This scoping review examined the phenomenon of autoresuscitation (autoROSC) and its outcomes in patients who underwent cardiopulmonary resuscitation (CPR). A total of 76 cases were identified, with the majority occurring in-hospital. The median time from CPR termination to autoROSC was 5 minutes. Overall, 31.58% of patients survived, indicating a potentially lower mortality rate than previously believed.
Background: The Lazarus phenomenon or autoresuscitation (autoROSC) is the return of spontaneous circulation (ROSC) after the termination of the cardiopulmonary resuscitation (CPR) efforts.Purpose: The purpose of the current scoping review is to present the available data in the literature regarding autoROSC.Methods: We reviewed four scientific databases to identify all studies which reported autoROSC cases in patients who underwent CPR. We then extracted all information relevant to CPR and autoROSC. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.Results: We identified 66 studies describing 76 autoROSC cases. The majority of cardiac arrests were in-hospital (44, 57.89%). Median time from termination of CPR to autoROSC was 5 min. Regarding the outcome, 52 (77.61%) patients died and 11 (14.47%) patients had intact neurological outcome. A higher mortality rate was identified in patients with respiratory comorbidities. Overall, 24 (31.58%) patients survived.Conclusion: AutoROSC is probably an under-reported event in the medical community. Healthcare professionals should be aware of the phenomenon and actively monitor for it, when appropriate.& COPY; 2023 Elsevier Inc. All rights reserved.

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