Abstract
Background
Cardiac arrest (CA) survivors experience cognitive deficits including post-traumatic
stress disorder (PTSD). It is unclear whether these are related to cognitive/mental
experiences and awareness during CPR. Despite anecdotal reports the broad range of
cognitive/mental experiences and awareness associated with CPR has not been systematically
studied.
Methods
The incidence and validity of awareness together with the range, characteristics and
themes relating to memories/cognitive processes during CA was investigated through
a 4 year multi-center observational study using a three stage quantitative and qualitative
interview system. The feasibility of objectively testing the accuracy of claims of
visual and auditory awareness was examined using specific tests. The outcome measures
were (1) awareness/memories during CA and (2) objective verification of claims of
awareness using specific tests.
Results
Among 2060 CA events, 140 survivors completed stage 1 interviews, while 101 of 140
patients completed stage 2 interviews. 46% had memories with 7 major cognitive themes:
fear; animals/plants; bright light; violence/persecution; deja-vu; family; recalling
events post-CA and 9% had NDEs, while 2% described awareness with explicit recall
of ‘seeing’ and ‘hearing’ actual events related to their resuscitation. One had a
verifiable period of conscious awareness during which time cerebral function was not
expected.
Conclusions
CA survivors commonly experience a broad range of cognitive themes, with 2% exhibiting
full awareness. This supports other recent studies that have indicated consciousness
may be present despite clinically undetectable consciousness. This together with fearful
experiences may contribute to PTSD and other cognitive deficits post CA.
Keywords
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Article info
Publication history
Published online: October 06, 2014
Accepted:
September 7,
2014
Received in revised form:
September 2,
2014
Received:
June 28,
2014
Footnotes
☆A Spanish translated version of the summary of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2014.09.004.
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
