Lazarus syndrome

Lazarus syndrome, (the Lazarus heart) also known as autoresuscitation after failed cardiopulmonary resuscitation,[1] is the spontaneous return of circulation after failed attempts at resuscitation.[2] Its occurrence has been noted in medical literature at least 38 times since 1982.[3][4] It takes its name from Lazarus who, as described in the New Testament, was raised from the dead by Jesus.[5]

Occurrences of the syndrome are extremely rare, and the causes are not well understood. One hypothesis for the phenomenon is that a chief factor (though not the only one) is the buildup of pressure in the chest as a result of cardiopulmonary resuscitation (CPR). The relaxation of pressure after resuscitation efforts have ended is thought to allow the heart to expand, triggering the heart's electrical impulses and restarting the heartbeat.[2] Other possible factors are hyperkalemia or high doses of epinephrine.[5]

Lazarus Syndrome
Other namesLazarus phenomenon

History

  • A 27-year-old man in the UK collapsed after overdosing on heroin and cocaine. Paramedics gave him an injection, and he recovered enough to walk to the ambulance. He went into cardiac arrest in transit. After 25 minutes of resuscitation efforts, the patient was verbally declared dead. About a minute after resuscitation ended, a nurse noticed a rhythm on the heart monitor and resuscitation was resumed. The patient recovered fully.[5]
  • A 66-year-old man suffering from a suspected abdominal aneurysm suffered cardiac arrest and received chest compressions and defibrillation shocks for 17 minutes during treatment for his condition. Vital signs did not return; the patient was declared dead and resuscitation efforts ended. Ten minutes later, the surgeon felt a pulse. The aneurysm was successfully treated, and the patient fully recovered with no lasting physical or neurological problems.[2]
  • According to a 2002 article in the journal Forensic Science International, a 65-year-old prelingually deaf Japanese male was found unconscious in the foster home he lived in. CPR was attempted on the scene by home staff, emergency medical personnel and also in the emergency department of the hospital and included appropriate medications and defibrillation. He was declared dead after attempted resuscitation. However, a policeman found the person moving in the mortuary after 20 minutes. The patient survived for 4 more days.[6]
  • Judith Johnson, 61, went into cardiac arrest at Beebe Medical Center in Lewes, Delaware, United States, in May 2007. She was given "multiple medicines and synchronized shocks", but never regained a pulse. She was declared dead at 8:34 p.m. but was discovered in the morgue to be alive and breathing. She sued the medical center where it happened for damages due to physical and neurological problems stemming from the event.[4]
  • A 45-year-old woman in Colombia was pronounced dead, as there were no vital signs showing she was alive. Later, a funeral worker noticed the woman moving and alerted his co-worker that the woman should go back to the hospital.[7][8]
  • A 65-year-old man in Malaysia came back to life two-and-a-half hours after doctors at Seberang Jaya Hospital, Penang, pronounced him dead. He died three weeks later.[9]
  • Anthony Yahle, 37, in Bellbrook, Ohio, USA, was breathing abnormally at 4 a.m. on 5 August 2013, and could not be woken. After finding that Yahle had no pulse, first responders administered CPR and were able to retrieve a stable-enough heartbeat to transport him to the Emergency Room. Later that afternoon, coded for 45 minutes at Kettering Medical Center and was pronounced dead after all efforts to resuscitate him failed. When his son arrived at the hospital to visit his supposed-to-be deceased father, he noticed a heartbeat on the monitor that was still attached to his father. Resuscitation efforts were resumed, and Yahle was successfully revived.[10]
  • Walter Williams, 78, from Lexington, Mississippi, United States, was at home when his hospice nurse called a coroner who arrived and declared him dead at 9 p.m. on 26 February 2014. Once at a funeral home, he was found to be moving, possibly resuscitated by a defibrillator implanted in his chest.[11] The next day he was well enough to be talking with family, but died fifteen days later.[12]

Record

  • Velma Thomas, 59, of West Virginia, USA holds the record time for recovering from clinical death. In May 2008, Thomas went into cardiac arrest at her home. Medics were able to establish a faint pulse after eight minutes of CPR. Her heart stopped twice after arriving at the hospital and she was placed on life support. She was declared clinically dead for 17 hours after doctors failed to detect any brain activity. Doctors attempted to lower her body temperature to stimulate brain activity. Her son, Tim Thomas, stated that "her skin had already started hardening, her hands and toes were curling up, they were already drawn". She was taken off life support and funeral arrangements were in progress. However, ten minutes after being taken off life support, she revived and recovered.[13][14]

Implications

The Lazarus phenomenon raises ethical issues for physicians, who must determine when medical death has occurred, resuscitation efforts should end, and postmortem procedures such as autopsies and organ harvesting may take place.[2]

Medical literature has recommended observation of a patient's vital signs for five to ten minutes after cessation of resuscitation before certifying death.[5]

See also

References

  1. ^ Hornby K, Hornby L, Shemie SD (May 2010). "A systematic review of autoresuscitation after cardiac arrest". Crit. Care Med. 38 (5): 1246–53. doi:10.1097/CCM.0b013e3181d8caaa. PMID 20228683.
  2. ^ a b c d Ben-David M.D., Bruce; et al. (2001). "Survival After Failed Intraoperative Resuscitation: A Case of "Lazarus Syndrome"". Anesthesia & Analgesia. 92 (3): 690–692. doi:10.1213/00000539-200103000-00027. PMID 11226103. Retrieved 28 July 2014.
  3. ^ Adhiyaman, Vedamurthy; Adhiyaman, Sonja; Sundaram, Radha. "The Lazarus phenomenon". Journal of the Royal Society of Medicine. 100 (12): 552–7. doi:10.1258/jrsm.100.12.552. PMC 2121643. PMID 18065707.
  4. ^ a b "Woman Declared Dead, Still Breathing in Morgue". Fox News. 7 October 2008. Retrieved 28 July 2014.
  5. ^ a b c d Walker, A.; H. McClelland; J. Brenchley (2001). "The Lazarus Documentary following recreational drug use". Emerg Med J. 18 (1): 74–75. doi:10.1136/emj.18.1.74. PMC 1725503. PMID 11310473. Retrieved 28 July 2014.
  6. ^ Maeda, H; Fujita, M. Q.; Zhu, B. L.; Yukioka, H; Shindo, M; Quan, L; Ishida, K (2002). "Death following spontaneous recovery from cardiopulmonary arrest in a hospital mortuary: 'Lazarus phenomenon' in a case of alleged medical negligence". Forensic Science International. 127 (1–2): 82–7. doi:10.1016/s0379-0738(02)00107-x. PMID 12098530.
  7. ^ "Embalmer finds 'dead' woman really alive". Bogota: NBC News. 17 February 2010. Retrieved 28 July 2014.
  8. ^ Salazar, Hernando. "¿Colombiana experimentó Síndrome de Lázaro?". BBC Online (in Spanish). Retrieved 26 December 2010.
  9. ^ Vinesh, Derrick (26 April 2011). "Resurrection man dies". The Star Online. Archived from the original on 5 January 2014. Retrieved 28 July 2014.
  10. ^ Lupkin, Sydney (22 August 2013). "Ohio Man Declared Dead Comes Back to Life". Retrieved 4 January 2014.
  11. ^ McLaughlin, Eliott (28 February 2014). "Dead Mississippi man begins breathing in embalming room, coroner says". CNN. Retrieved 28 February 2014.
  12. ^ Ford, Dana (13 March 2014). "Mississippi man who awoke in body bag dies two weeks later". CNN. Retrieved 13 March 2014.
  13. ^ Elsworth, Catherine (26 May 2008). "Woman comes back to life after being dead for 17 hours". Telegraph.co.uk. Retrieved 9 June 2019.
  14. ^ "Woman Came Back From the Dead After 17 Hours with No Measurable Brain Waves". Neatorama. 27 May 2008. Retrieved 9 June 2019.

External links

Algor mortis

Algor mortis (Latin: algor—coldness; mortis—of death), the second stage of death, is the change in body temperature post mortem, until the ambient temperature is matched. This is generally a steady decline, although if the ambient temperature is above the body temperature (such as in a hot desert), the change in temperature will be positive, as the (relatively) cooler body acclimates to the warmer environment. External factors can have a significant influence.

The term was first used by Dowler in 1849. The first published measurements of the intervals of temperature after death were done by Dr John Davey in 1839.

Bamforth–Lazarus syndrome

Bamforth–Lazarus syndrome is a genetic condition that results in thyroid dysgenesis. It is due to recessive mutations in forkhead/winged-helix domain transcription factor (FKLH15 or TTF2).It is associated with FOXE1.

Dead on arrival

Dead on arrival (DOA), also dead in the field and brought in dead (BID), indicates that a patient was found to be already clinically dead upon the arrival of professional medical assistance, often in the form of first responders such as emergency medical technicians, paramedics, or police.

In some jurisdictions, first responders must consult verbally with a physician before officially pronouncing a patient deceased, but once cardiopulmonary resuscitation is initiated, it must be continued until a physician can pronounce the patient dead.

Death messenger

Death messengers, in former times, were those who were dispatched to spread the news that an inhabitant of their city or village had died. They were to wear unadorned black and go door to door with the message, "You are asked to attend the funeral of the departed __________ at (time, date, and place)." This was all they were allowed to say, and were to move on to the next house immediately after uttering the announcement. This tradition persisted in some areas to as late as the mid-19th century.

Death rattle

Terminal respiratory secretions (or simply terminal secretions), known colloquially as a death rattle, are sounds often produced by someone who is near death as a result of fluids such as saliva and bronchial secretions accumulating in the throat and upper chest. Those who are dying may lose their ability to swallow and may have increased production of bronchial secretions, resulting in such an accumulation. Usually, two or three days earlier, the symptoms of approaching death can be observed as saliva accumulates in the throat, making it very difficult to take even a spoonful of water. Related symptoms can include shortness of breath and rapid chest movement. While death rattle is a strong indication that someone is near death, it can also be produced by other problems that cause interference with the swallowing reflex, such as brain injuries.It is sometimes misinterpreted as the sound of the person choking to death, or alternatively, that they are gargling.

Dignified death

Dignified death is a somewhat elusive concept often related to suicide. One factor that has been cited as a core component of dignified death is maintaining a sense of control. Another view is that a truly dignified death is an extension of a dignified life. There is some concern that assisted suicide does not guarantee a dignified death, since some patients may experience complications such as nausea and vomiting. There is some concern that age discrimination denies the elderly a dignified death.

Dysthanasia

In medicine, dysthanasia means "bad death" and is considered a common fault of modern medicine.Dysthanasia occurs when a person who is dying has their biological life extended through technological means without regard to the person's quality of life. Technologies such as an implantable cardioverter defibrillator, artificial ventilation, ventricular assist devices, and extracorporeal membrane oxygenation can extend the dying process.

Dysthanasia is a term generally used when a person is seen to be kept alive artificially in a condition where, otherwise, they cannot survive; sometimes for some sort of ulterior motive. The term was used frequently in the investigation into the death of Formula One driver Ayrton Senna in 1994.

Lazarus sign

The Lazarus sign or Lazarus reflex is a reflex movement in brain-dead or brainstem failure patients, which causes them to briefly raise their arms and drop them crossed on their chests (in a position similar to some Egyptian mummies). The phenomenon is named after the Biblical figure Lazarus of Bethany, whom Jesus raised from the dead in the Gospel of John.

Megadeath

Megadeath (or megacorpse) is one million human deaths, usually caused by a nuclear explosion. The term was used by scientists and thinkers who strategized likely outcomes of all-out nuclear warfare.

Necronym

A necronym (from the Greek words νεκρός, nekros, "dead" and ὄνομα ónoma, "name") is a reference to, or name of, a person who has died. Many cultures have taboos and traditions associated with referring to such a person. These vary from the extreme of never again speaking the person's real name, often using some circumlocution instead, to the opposite extreme of commemorating it incessantly by naming other things or people after the deceased.

For instance, in some cultures it is common for a newborn child to receive the name (a necronym) of a relative who has recently died, while in others to reuse such a name would be considered extremely inappropriate or even forbidden. While this varies from culture to culture, the use of necronyms is quite common.

Necrophobia

Necrophobia is a specific phobia which is the irrational fear of dead things (e.g., corpses) as well as things associated with death (e.g., coffins, tombstones, funerals, cemeteries). With all types of emotions, obsession with death becomes evident in both fascination and objectification. In a cultural sense, necrophobia may also be used to mean a fear of the dead by a cultural group, e.g., a belief that the spirits of the dead will return to haunt the living.Symptoms include: shortness of breath, rapid breathing, irregular heartbeat, sweating, dry mouth and shaking, feeling sick and uneasy, psychological instability, and an altogether feeling of dread and trepidation. The sufferer may feel this phobia all the time. The sufferer may also experience this sensation when something triggers the fear, like a close encounter with a dead animal or the funeral of a loved one or friend. The fear may have developed when a person witnessed a death, or was forced to attend a funeral as a child. Some people experience this after viewing frightening media.The fear can manifest itself as a serious condition. Treatment options include medication and therapy.The word necrophobia is derived from the Greek nekros (νεκρός) for "corpse" and the Greek phobos (φόβος) for "fear".

Obituary

An obituary (obit for short) is a news article that reports the recent death of a person, typically along with an account of the person's life and information about the upcoming funeral. In large cities and larger newspapers, obituaries are written only for people considered significant. In local newspapers, an obituary may be published for any local resident upon death. A necrology is a register or list of records of the deaths of people related to a particular organization, group or field, which may only contain the sparsest details, or small obituaries. Historical necrologies can be important sources of information.

Two types of paid advertisements are related to obituaries. One, known as a death notice, omits most biographical details and may be a legally required public notice under some circumstances. The other type, a paid memorial advertisement, is usually written by family members or friends, perhaps with assistance from a funeral home. Both types of paid advertisements are usually run as classified advertisements.

Pallor mortis

Pallor mortis (Latin: pallor "paleness", mortis "of death"), the first stage of death, is an after-death paleness that occurs in those with light/white skin.

Post-mortem interval

Post-mortem interval (PMI) is the time that has elapsed since a person has died. If the time in question is not known, a number of medical/scientific techniques are used to determine it. This also can refer to the stage of decomposition of the body.

Resurrection

Resurrection or anastasis is the concept of coming back to life after death. In a number of ancient religions, a dying-and-rising god is a deity which dies and resurrects.

The resurrection of the dead is a standard eschatological belief in the Abrahamic religions. As a religious concept, it is used in two distinct respects: a belief in the resurrection of individual souls that is current and ongoing (Christian idealism, realized eschatology), or else a belief in a singular resurrection of the dead at the end of the world. Some believe the soul is the actual vehicle by which people are resurrected.The death and resurrection of Jesus, an example of resurrection, is the central focus of Christianity. Christian theological debate ensues with regard to what kind of resurrection is factual – either a spiritual resurrection with a spirit body into Heaven, or a material resurrection with a restored human body. While most Christians believe Jesus' resurrection from the dead and ascension to Heaven was in a material body, a very small minority believes it was spiritual.There are documented rare cases of the return to life of the clinically dead which are classified scientifically as examples of the Lazarus syndrome, a term originating from the biblical story of the resurrection of Lazarus.

Ronald Hunter

Ronald Lee "Ron" Hunter (June 14, 1943 – December 3, 2013) was an American actor, whose career spanned nearly five decades in television, film and theater.Hunter was born in Boston, Massachusetts, and raised in the suburb of Brookline. Most of his credits were television appearances. Until 1979, he performed roles in mostly New York City stage productions, like Lord Hastings in the Broadway production of Richard III. He previously appeared in One Life to Live, the PBS docudrama The Edelin Conversation as Dr. Kenneth Edelin, and Kojak as "a perennial undergraduate". His first major television appearance was The Lazarus Syndrome, co-starring Louis Gossett, Jr. He portrayed a minor role in the 1979 film The Seduction of Joe Tynan, starring Alan Alda. He also co-starred in the 1980s PBS miniseries, Three Sovereigns for Sarah, and the pilot film of the CBS series Cagney and Lacey as Harvey Lacey. He portrayed one of the case suspects in the 1988 made-for-television film Internal Affairs, starring Richard Crenna. He also appeared in Along Came Polly (2004), Law & Order (1991) and The Big Bang Theory (2008).

Hunter died of heart and kidney failure on December 3, 2013, aged 70, at the Woodland Hills Medical Center in Los Angeles, California. He was survived by his three children, two grandchildren and sister.

The Adventures of Superman (BBC Radio series)

The Adventures of Superman was a six-part radio drama commissioned by BBC Radio 4 and broadcast in 1988.

The Lazarus Syndrome

The Lazarus Syndrome is a 1979 American made-for-television drama thriller film directed by Jerry Thorpe. It was later the basis for a weekly television series of the same name, airing on the ABC network.

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