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AWAreness during REsuscitation - II: A multi-center study of consciousness and awareness in cardiac arrest
Journal article   Open access   Peer reviewed

AWAreness during REsuscitation - II: A multi-center study of consciousness and awareness in cardiac arrest

Sam Parnia, Tara Keshavarz Shirazi, Jignesh Patel, Linh Tran, Niraj Sinha, Caitlin O'Neill, Emma Roellke, Amanda Mengotto, Shannon Findlay, Michael McBrine, …
Resuscitation, v 191, 109903
01 Oct 2023
DOI: https://doi.org/10.1016/j.resuscitation.2023.109903
PMID: 37423492
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.resuscitation.2023.109903View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Cardiac arrest Cardiopulmonary Resuscitation (CPR) Consciousness Near-Death Experiences (NDE) Recalled Experience of Death (RED)
Cognitive activity and awareness during cardiac arrest (CA) are reported but ill understood. This first of a kind study examined consciousness and its underlying electrocortical biomarkers during cardiopulmonary resuscitation (CPR). In a prospective 25-site in-hospital study, we incorporated a) independent audiovisual testing of awareness, including explicit and implicit learning using a computer and headphones, with b) continuous real-time electroencephalography(EEG) and cerebral oxygenation(rSO2) monitoring into CPR during in-hospital CA (IHCA). Survivors underwent interviews to examine for recall of awareness and cognitive experiences. A complementary cross-sectional community CA study provided added insights regarding survivors’ experiences. Of 567 IHCA, 53(9.3%) survived, 28 of these (52.8%) completed interviews, and 11(39.3%) reported CA memories/perceptions suggestive of consciousness. Four categories of experiences emerged: 1) emergence from coma during CPR (CPR-induced consciousness [CPRIC]) 2/28(7.1%), or 2) in the post-resuscitation period 2/28(7.1%), 3) dream-like experiences 3/28(10.7%), 4) transcendent recalled experience of death (RED) 6/28(21.4%). In the cross-sectional arm, 126 community CA survivors’ experiences reinforced these categories and identified another: delusions (misattribution of medical events). Low survival limited the ability to examine for implicit learning. Nobody identified the visual image, 1/28(3.5%) identified the auditory stimulus. Despite marked cerebral ischemia (Mean rSO2 = 43%) normal EEG activity (delta, theta and alpha) consistent with consciousness emerged as long as 35–60 minutes into CPR. Consciousness. awareness and cognitive processes may occur during CA. The emergence of normal EEG may reflect a resumption of a network-level of cognitive activity, and a biomarker of consciousness, lucidity and RED (authentic “near-death” experiences).

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43 citations in Web of Science
35 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Critical Care Medicine
Emergency Medicine
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