The Lazarus Phenomenon - A Remarkable Case of Spontaneous Recovery from Cardiac Arrest in a Do-Not-Resuscitate...

The Lazarus phenomenon, or autoresuscitation, is a rare clinical entity defined as the spontaneous return of circulation in patients following cardiac arrest. Here we report the case of an 88-year-old female who suffered cardiac arrest and received no intervention due to her code status. Despite this, she regained a pulse and consciousness after 167 seconds of pulseless ventricular tachycardia and 108 seconds of asystole consecutively, surviving through pacemaker placement and discharging 5 days later with an intact neurological status. We demonstrate that although rare, favorable outcomes with autoresuscitation are possible, even when no intervention is provided. We also provide a novel explanation for her recovery adding to existing theories on the mechanism of autoresuscitation.

Despite its rarity, autoresuscitation may result in favorable neurologic and functional outcomes even when cardiopulmonary resuscitation is not attempted.Patients should be monitored for at least 5 minutes prior to determination of circulatory death.