What Is Lazarus Syndrome?

Lazarus syndrome, more formally known as "auto-resuscitation after failed cardiopulmonary resuscitation," is a recognized medical phenomenon where a patient is pronounced dead after all vital sign have to ceased only to suddenly come back to life. Named after Lazarus, a Biblical figure who was brought back life by Jesus after four days of death, the occurrence of the syndrome is very rare. People who have had Lazarus syndrome include cardiac patients and patients with obstructive airway disease.

There are a number of theories as to how Lazarus syndrome can occur. The spontaneous reanimation may be due to the delayed effects of the medications that are given to the patient. For example, in heart patients, there may be a delay of the effects of the administration of adrenalin. In hyperkalemic patients, the effects of bicarbonate may take longer than expected to work. When these medications do finally take action, however, circulation is spontaneously reinitiated.

There may also be a buildup of endovascular plaque, which upon administration of cardiopulmonary resuscitation, is dislodged after a delayed period of time. Although delayed, this action subsequently allows the heart to restart. Finally, in patients with obstructive airway disease, hyperventilation and an inability to properly exhale create a significant amount of pressure in the chest. Once vital signs have ceased and the patient stops breathing, there may be a relief of this hyperinflation and resulting pressure, allowing normal body function to begin.

The occurrence of Lazarus syndrome may be more common than it appears. There may be a lack of reporting of the phenomenon due to the legal and physiological implications that it can have. The hospital and doctor, for example, may be held legally responsible for mispronouncing the individual as dead and discontinuing life-saving measures that may preserve mental and physical function. The competence of the staff involved might be called into question, and the sheer lack of physiological explanation in some cases can create significant unease and disbelief.

Lazarus syndrome has brought a number of questions to the medical community about the certainty of death and what this may mean for some procedures. For example, situations such as nonbeating heart organ donation, when a person on life support is unplugged immediately prior to donation, have raised questions about when a person can be considered dead. Other questions have been provoked regarding when resuscitation efforts should be ceased and how long after a person is pronounced dead should an autopsy be performed. For many people, this phenomena brings to mind the Victorian practice of burying a loved one with a string in hand attached to a bell on the surface, just in case.