@article{Karlis2026,
abstract = {Death is a process, rather than a time specific event. Lazarus phenomenon/syndrome is a rare occurrence of restoration of spontaneous circulation after a patient has been declared dead. It is also known as autoresuscitation. We sought to review the relevant literature to investigate the features, frequency, pathophysiology and clinical implications of the syndrome. It seems that autoresuscitation usually takes place in the first few minutes after termination of resuscitation efforts. Approximately 82% of reported cases occur within 10 min of CPR discontinuation. There are a few outliers of Lazarus phenomenon appearing as late as 20 to 50 minutes. The prognosis of the syndrome is dismal, as the majority die before hospital discharge. However, studies report full recovery in 14-28% of patients. The exact cause of Lazarus phenomenon is not fully understood. Several theories have been proposed (e.g. hyperventilation/air trapping, delayed drug action, myocardial stunning), but it is likely that the mechanism is multifactorial. The resumption of cardiac activity after withdrawal of life-sustaining measures has been studied. All the cases occurred within 4 minutes and 20 seconds after a period of pulselessness. We would like to emphasize that autoresuscitation is possible in any cardiac arrest victim, regardless of whether CPR was applied. Current evidence suggests that a “no touch” period of no less than 5 minutes is sufficient for controlled donation after circulatory death (DCD). However, in the case of uncontrolled DCD (organ donation after unsuccessful CPR), a longer “no touch” period may be needed to exclude Lazarus phenomenon.},
author = {Karlis, George and Frantzeskaki, Frantzeska and Tsangari, Irakliss},
doi = {10.32114/CCI.2026.9.2.20.27},
journal = {Critical Care Innovations},
number = {2},
pages = {20--27},
title = {{he Lazarus phenomenon – coming back from the underworld: current knowledge and novel perspectives.}},
url = {https://www.irdim.net/cci/9(2)20-27.html},
volume = {9},
year = {2026}
}