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. 2023 Oct:72:44-57.
doi: 10.1016/j.ajem.2023.07.017. Epub 2023 Jul 17.

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

Georgios Mavrovounis  1 , Marina Kontou  2 , Orestis Tsiotsikas  2 , Maria Mermiri  3 , Vasiliki Tsolaki  4 , Eleftherios Beltsios  5 , Konstantinos Gourgoulianis  6 , Athanasios Chalkias  7 , Ioannis Pantazopoulos  8
Affiliations

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

Georgios Mavrovounis et al. Am J Emerg Med. 2023 Oct.

Abstract

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.

Keywords: Autoresuscitation; CPR; Cardiopulmonary resuscitation; Lazarus phenomenon; Resuscitation.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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