AWARE-AWAreness during REsuscitation-a prospective study.

Area of Science:

• Medical research
• Neuroscience
• Psychology

Background:

• Cardiac arrest (CA) survivors frequently experience cognitive deficits, including post-traumatic stress disorder (PTSD).
• The relationship between cognitive/mental experiences during cardiopulmonary resuscitation (CPR) and these deficits remains unclear.
• Systematic studies on the range and nature of cognitive experiences during CPR are lacking.

Purpose of the Study:

• To investigate the incidence and validity of awareness during CA.
• To explore the range, characteristics, and themes of memories and cognitive processes during CA.
• To examine the feasibility of objectively verifying claims of awareness during CPR.

Main Methods:

• A 4-year multi-center observational study using a three-stage quantitative and qualitative interview system.
• Investigated 2060 cardiac arrest events, interviewing 140 survivors in stage 1 and 101 in stage 2.
• Employed specific tests to objectively verify claims of visual and auditory awareness during CPR.

Main Results:

• 46% of survivors reported memories with themes including fear, bright light, and family.
• 9% experienced near-death experiences (NDEs), and 2% reported verifiable awareness with explicit recall of resuscitation events.
• One case demonstrated verifiable conscious awareness during a period when cerebral function was not expected.

Conclusions:

• A significant proportion of cardiac arrest survivors report diverse cognitive themes and memories during resuscitation.
• 2% of survivors exhibited verifiable awareness, suggesting consciousness may persist despite undetectable brain activity.
• These experiences, particularly fearful ones, may contribute to the development of PTSD and other cognitive impairments post-cardiac arrest.