CPR-related cognitive activity, consciousness, awareness and recall, and its management: A scoping review.
Rebecca L West, Quentin Otto, Ian R Drennan, Sarah Rudd, Bernd W Böttiger, Sam Parnia, Jasmeet Soar
Resuscitation Plus May 9, 2022 DOI: 10.1016/j.resplu.2022.100241 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Scoping review Peer reviewed |
|---|---|
| Population | Patients undergoing cardiopulmonary resuscitation and professional rescuers, as reported in observational studies and case reports |
| Topics | PTSD |
| Keywords | Awareness Consciousness Cardiac arrest Cardiopulmonary resuscitation Or, odds ratio Near death experience Ed, emergency department Vf, ventricular fibrillation Vt, ventricular tachycardia Cpr, cardiorespiratory resuscitation |
| Key findings | Reported prevalence of CPR-induced consciousness ranged from 0.23% to 0.9% of resuscitation attempts, and 48-59% of experienced professional rescuers surveyed estimated having observed it. CPR-induced consciousness was associated with professional rescuer CPR, witnessed arrest, a shockable rhythm, increased return of spontaneous circulation, and survival to hospital discharge. The authors report few studies of sedation for CPR-induced consciousness and no widely accepted treatment guidance. |
Abstract
Background: There are increasing numbers of reports of cognitive activity, consciousness, awareness and recall related to cardiopulmonary resuscitation (CPR) and interventions such as the use of sedative and analgesic drugs during CPR.
Objectives: This scoping review aims to describe the available evidence concerning CPR-related cognitive activity, consciousness, awareness and recall and interventions such as the use of sedative and analgesic drugs during CPR.
Methods: A literature search was conducted of Medline, Embase and CINAHL from inception to 21 October 2021. We included case studies, observational studies, review studies and grey literature.
Results: We identified 8 observational studies including 40,317 patients and 464 rescuers, and 26 case reports including 33 patients. The reported prevalence of CPR-induced consciousness was between 0.23% to 0.9% of resuscitation attempts, with 48-59% of experienced professional rescuers surveyed estimated to have observed CPR-induced consciousness. CPR-induced consciousness is associated with professional rescuer CPR, witnessed arrest, a shockable rhythm, increased return of spontaneous circulation (ROSC), and survival to hospital discharge when compared to patients without CPR-induced consciousness. Few studies of sedation for CPR-induced consciousness were identified. Although local protocols for treating CPR-induced consciousness exist, there is no widely accepted guidance.
Conclusions: CPR-related cognitive activity, consciousness, awareness and recall is uncommon but increasingly reported by professional rescuers. The data available was heterogeneous in nature and not suitable for progression to a systematic review process. Although local treatment protocols exist for management of CPR-induced consciousness, there are no widely accepted treatment guidelines. More studies are required to investigate the management of CPR-induced consciousness.
Comparable studies
Other narrative reviews on PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychedelic Psychiatry's Brave New World. | 2020 | Review | |
| Reviewing the Potential of Psychedelics for the Treatment of PTSD | 2020 | Review | |
| Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA. | 2016 | Review | |
| MDMA-assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms? | 2018 | Review | |
| Clinical applications of hallucinogens: A review. | 2016 | Review |
Citations in the library
Cited by 2
Cites 3
- The Near-Death Experience Scale The Journal of Nervous and Mental Disease June 1, 1983
- AWARE-AWAreness during REsuscitation-a prospective study. Resuscitation October 7, 2014
- Do reports of consciousness during cardiac arrest hold the key to discovering the nature of consciousness? Medical Hypotheses April 24, 2007