Lazarus Syndrome - Challenges Created by Pediatric Autoresuscitation

作者：Mullen, Stephen^*; Roberts, Zoe; Tuthill, David; Owens, Laura; Naude, Johann Te Water; Maguire, Sabine

来源：Pediatric Emergency Care, 2021, 37(4): E210-E211.

DOI：10.1097/PEC.0000000000001593

• ethics
• general pediatrics
• intensive care
• neurology
• resuscitation

Pediatric autoresuscitation is extremely rare, with only 4 documented cases in the literature. The longest recorded time between stopping cardio pulmonary resuscitation (CPR) and return of spontaneous circulation is 2 minutes. We report a previously well 18-month-old who attended the emergency department after an unexplained cardiac arrest. After 10 cycles of CPR, resuscitation was stopped; 6 minutes later, the patient had a return of spontaneous circulation and was transferred to the pediatric intensive care unit. The patient remains alive but with significant neurological impairment. There are a variety of theories regarding the pathology of pediatric autoresuscitation. The most commonly accepted model is that there is a degree of autopositive end-expiratory pressure impending venous return as a consequence of vigorous ventilation during CPR. This case challenges clinicians to reassess our current definition of death and reaffirms the need for clearer guidelines surrounding the certification of death.

• 出版日期2021-4