It’s one of those moments in medicine, and indeed in life, that just stops you in your tracks. Imagine this: a medical team has done everything they can. They’ve performed CPR (cardiopulmonary resuscitation), but sadly, the person hasn’t responded. With heavy hearts, they declare the time of death. And then… a flicker. A breath. A pulse. It sounds like something from a movie, doesn’t it? This incredibly rare and perplexing event is what we call the Lazarus effect.
So, What Exactly is the Lazarus Effect?
The more technical term we use in medicine is autoresuscitation. It basically means that someone’s circulation – their heart starting to beat and pump blood again – spontaneously comes back after CPR has been stopped and they’ve been declared clinically dead.
Now, the name “Lazarus” comes from a biblical story of a man raised from the dead. But let’s be clear, in these medical situations, it’s not that someone has truly died and then resurrected. Instead, it seems there’s a delay in their circulation returning. This delay makes it appear as though they’ve passed away, only to show signs of life minutes, or sometimes even a bit longer, later. It’s a profound and often very emotional situation for everyone involved, especially families.
Here’s generally how it unfolds:
- A person experiences a cardiac arrest (their heart stops).
- Someone, often a healthcare professional, starts CPR.
- Despite these efforts, it appears CPR isn’t working, and the person is declared to have passed.
- No more medical interventions are performed.
- Then, unexpectedly, someone notices signs of life – maybe a gasp, a movement. These signs have to be more than just a fleeting moment.
- A medical check confirms that their circulation has indeed returned, and, of course, medical care is immediately restarted.
Most of the time, when this happens, signs of life are noticed within about 10 minutes of stopping CPR. But, as I said, it can be longer.
How Often Does This Happen, and Why?
The Lazarus effect is, thankfully, very rare. If you look through medical journals, there are only about 65 documented cases between 1982 and 2018. Out of those, 18 people actually went on to make a full recovery. It’s quite possible it happens more often than we have documented, as not every instance might get written up. We don’t know exactly why it occurs, or who might be more prone to it, though most reported cases have been in folks over 60. It can happen whether someone is in the hospital or outside of it.
So, what’s our best guess for why the Lazarus effect occurs? Well, one leading idea is that during CPR, especially if it’s very vigorous, a lot of air can get pushed into the lungs very quickly. This is called hyperinflation. Think of it like over-inflating a balloon. This can build up pressure inside the chest.
That high pressure can actually squeeze the blood vessels, making it harder for blood to flow back to the heart. When CPR stops, this pressure can suddenly release. As the pressure drops, blood might then be able to rush back into the heart, and sometimes, just sometimes, this can be enough to get it to start beating again on its own. It’s a complex theory, and honestly, we’re still learning.
Unfortunately, even when autoresuscitation happens, many people don’t survive for very long afterwards. It’s often a brief return of circulation.
What Can Be Done? Understanding the Medical Approach
Because the Lazarus effect can be so distressing for families – that glimmer of hope followed by, often, further loss – medical professionals have looked at ways to reduce the chance of declaring death prematurely. It’s about being as certain as possible. Some of the guidelines that have come out of this include:
- Continuing CPR for a good amount of time, generally at least 20 minutes.
- Being careful during CPR to avoid that hyperinflation we talked about. For instance, current guidelines often suggest a certain number of breaths per minute, say around 10-12.
- Not stopping CPR immediately after using a defibrillator (the machine that gives an electric shock). Sometimes, the heart can show a flat line, or asystole, right after a shock, but it might recover.
- Carefully monitoring a person for at least 10 minutes after CPR has stopped before a declaration of death is made.
Thinking about these kinds of situations can feel overwhelming, I know. But it also highlights why it’s so valuable to think about and share your wishes for end-of-life care. Having conversations with your loved ones and your doctor about what you would, or wouldn’t, want in terms of life support, including CPR, can bring a lot of peace of mind. You might also consider appointing someone you trust to make medical decisions for you if you can’t – that’s called a healthcare power of attorney. These aren’t easy topics, but they are important ones.
Take-Home Message: Understanding the Lazarus Effect
Here’s what I’d really like you to remember about the Lazarus effect:
- It’s a very rare event where someone’s circulation returns on its own after CPR has stopped and they’ve been declared deceased. The medical term is autoresuscitation.
- It’s not a true resurrection; it’s more like a delayed return of the heart’s function.
- The exact cause isn’t fully understood, but one theory involves pressure changes in the chest related to CPR.
- Medical guidelines aim to prevent premature declarations of death by recommending extended observation after CPR stops.
- Sadly, most individuals who experience this don’t survive for long.
- This phenomenon underscores the importance of discussing and documenting your end-of-life care wishes.
It’s one of those mysteries of medicine that reminds us how complex the human body is. You’re not alone in finding this both fascinating and a bit unsettling.