Autoresuscitation is the spontaneous return of cardiocirculatory function after observed asystole without active resuscitation measures. In the English-speaking world it is also called the Lazarus phenomenon.
The phenomenon is medically documented but rare. The longest case documented in the literature stands at 4 minutes 20 seconds (Dhanani et al., NEJM multicentre study). The five-minute observation phase in the protocol for organ donation after circulatory arrest is built on this empirical evidence: it is meant to rule out autoresuscitation with certainty.
Significance for the Practice of Organ Donation after Circulatory Arrest
Autoresuscitation is the empirical gap between asystole and definitive death that must be closed by the protocol for organ donation after circulatory arrest. Without an observation interval, the determination of death after asystole would be premature; with the five-minute rule, the spontaneous return is empirically excluded.
Important in substance-ontological terms: even after the five-minute interval has elapsed, autoresuscitation is merely empirically improbable, not anatomically impossible. On the position defended here it therefore holds: five minutes of permanence suffice for the definition of permanence, but not for irreversibility — and thus not for definitive death in the substance-ontological sense (cf. precautionary principle).
Clinical Context
Autoresuscitation typically occurs:
- after terminated cardiopulmonary resuscitation (CPR)
- in patients whose circulation is under pharmacological influence
- rarely also without any identifiable trigger
In the practice of organ donation after circulatory arrest, autoresuscitation is one of the central safety parameters that empirically grounds confidence in the stipulation of permanence.
Ontological Classification
Superordinate concept: Event (within the process of dying)
Ontological relations:
- object of observation in: Five-minute observation
- defines the empirical basis for: Permanence
- limits the certainty of the: practice of organ donation after circulatory arrest
Chapter assignment: Chapter 4: What Is Human Personhood? (German)
Sources
- Hornby, Karen; Hornby, Laura; Shemie, Sam D. (2010): A systematic review of autoresuscitation after cardiac arrest. Critical Care Medicine 38(5): 1246—1253.
- Hornby, Laura; Dhanani, Sonny; Shemie, Sam D. (2018): Update of a systematic review of autoresuscitation after cardiac arrest. Critical Care Medicine 46(3): e268—e272.
- Zorko, David J.; Shemie, Sam D.; Hornby, Laura; et al. (2023): Autoresuscitation after circulatory arrest: an updated systematic review. Canadian Journal of Anesthesia 70(4): 699—712. https://link.springer.com/article/10.1007/s12630-023-02411-8
- Manton, A. (2024): Back to life from being declared dead in the Resus Bay: An integrative review of the phenomenon of autoresuscitation. Emergency Medicine Australasia.
See also
- Five-Minute Observation
- Asystole
- Permanence and Irreversibility
- Organ Donation after Circulatory Arrest
- Precautionary Principle
- Dead Donor Rule
- Benedict XVI
Connections to Related Concepts
Generated by querying the Personhood ontology.