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Related Experiment Video

Updated: Sep 20, 2025

Establishment of Deep Hypothermic Circulatory Arrest in Rats
08:39

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Consciousness in deep hypothermic circulatory arrest: a feasibility study.

Joshua Ross1, Thomas Jan2, Deane Smith2

  • 1NYU Langone Health, 550 1 stAvenue, New York, NY, 10010, USA. Joshua.Ross@nyulangone.org.

Journal of Cardiothoracic Surgery
|May 28, 2025
PubMed
Summary

Consciousness during deep hypothermic circulatory arrest (DHCA) is feasible to study. Some patients showed implicit learning and electrocortical biomarkers of consciousness, suggesting awareness despite no visible signs.

Keywords:
Cardiac ArrestCardiac standstillCirculatory arrestConsciousnessDHCAEEGLearning

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Area of Science:

  • Neuroscience
  • Cardiovascular Surgery
  • Critical Care Medicine

Background:

  • Consciousness during deep hypothermic circulatory arrest (DHCA) remains unexplored.
  • Previous studies in cardiac arrest suggest a spectrum of consciousness.
  • This study investigates the feasibility of assessing consciousness during DHCA.

Purpose of the Study:

  • To determine the feasibility of studying consciousness during DHCA.
  • To assess implicit learning and explicit recall in DHCA patients.
  • To measure electrocortical markers of consciousness and cerebral oxygenation.

Main Methods:

  • Prospective study in 36 DHCA patients undergoing thoracic aortic aneurysm repair or pulmonary endarterectomy across 10 hospitals.
  • Audiovisual stimuli delivered via tablet and headphones to test implicit learning and explicit recall.
  • Electroencephalography (EEG) and near-infrared spectroscopy (NIRS) used to monitor brain activity and oxygenation.

Main Results:

  • Feasibility established: 81% had tablet setup, 100% had EEG/NIRS setup.
  • EEG data showed delta waves in 33% and theta waves in 11% during arrest; others showed isoelectric patterns.
  • No explicit recall of stimuli, but 9% showed implicit learning (guessing fruits) and 9% recalled other memories.

Conclusions:

  • A spectrum of consciousness, including implicit learning and electrocortical biomarkers, may exist during DHCA.
  • These findings suggest awareness despite the absence of visible signs of consciousness.
  • Potential to explain psychological outcomes in cardiac arrest survivors.