拉撒路综合征

The Lazarus Syndrome

拉撒路综合征，是指在心肺复苏失败停止所有抢救措施后，包括停止胸外按压、停止呼吸机辅助通气、停止输液及抢救药物应用等，无原因自主循环恢复，所以又被称为迟发的自主循环恢复。自首例报道于1982年，目前已经有53例个案报告。拉撒路综合征的病理生理及其发生机制，目前医学界并没有一个确切的定论。呼气末正压释放假说、高血钾堆积、碱中毒、肾上腺素等药物堆积效应等假说纷纷被提出。大多数的病例报告中拉撒路综合征发生在心肺复苏停止10min之内，所以大多数文献中建议在心肺复苏停止后，对患者的积极监护至少应该持续10min，以此来确定是患者是否真的死亡。但这一建议仍需要更多的研究支持。

The Lazarus phenomenon is defined as delayed ROSC, or ROSC after failure of CPR and cessation of all the emergency medical care, including the cessation of chest compression, mechanical ventilation, and venous fluid resuscitation. It was first reported in 1982 and 53 cases of Lazarus phenomenon have been reported in the medical literature so far. Even though Lazarus phenomenon is rare and the pathophysiological mechanisms are poorly understood, several possible mechanisms are still proposed, which could be rational to explain this phenomenon, such as auto-PEEP, hyperkalemia, alkalosis, delayed action of drugs, etc. In most cases, it was reported that ROSC occurred within 10 minutes after cessation of medical effort. Therefore, before the announcement of death of patient, it is mandatory to monitor those patients for at least 10 minutes after the cessation of CPR. However, more explicit studies seem to be necessary to gain a better understanding of this phenomenon.