AWARE--AWAreness during REsuscitation--A prospective study
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Plain English Summary
What happens to your mind when your heart stops? This landmark four-year study β the largest of its kind β tracked over 2,000 cardiac arrest cases across 15 hospitals in the US, UK, and Austria to find out. Of the 140 survivors who could be interviewed, a surprising 55% reported some kind of mental experience during the time they were clinically dead: 46% had memories with non-NDE cognitive themes (fear, bright light, family, deja-vu, violence), while 9% had what matched the classic definition of a near-death experience (think tunnels of light and life reviews). Two percent described full, vivid awareness β actually seeing and hearing the medical team working on them. The showstopper: one patient accurately described specific resuscitation details during a roughly three-minute window when their brain should have had zero function, and staff confirmed the account. That single verified case is a big deal in the debate over whether consciousness can exist independently of brain activity. The findings were compelling enough to launch an even larger follow-up study called AWARE II.
Abstract
Background: Cardiac arrest (CA) survivors experience cognitive deο¬cits 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 speciο¬c tests. The outcome measures were (1) awareness/memories during CA and (2) objective veriο¬cation of claims of awareness using speciο¬c 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 veriο¬able 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 deο¬cits post CA.
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Extends
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- The Central Clinical Relevance of Near-Death Experiences in Acute Care Contexts β Michael, Pascal (2025)
- The Mystical Experience and Its Neural Correlates β Woollacott, Marjorie (2020)
- Epistemological Implications of Near-Death Experiences and Other Non-Ordinary Mental Expressions: Moving Beyond the Concept of Altered State of Consciousness β Facco, Enrico (2015)
- Neuro-Functional Modeling of Near-Death Experiences in Contexts of Altered States of Consciousness β Romand, Raymond (2023)
Companion
- Consistency of Near-Death Experience Accounts over Two Decades: Are Reports Embellished over Time? β Greyson, Bruce (2007)
- Characteristics of Near-Death Experiences Memories as Compared to Real and Imagined Events Memories β Thonnard, Marie (2013)
- Explanation of Near-Death Experiences: A Systematic Analysis of Case Reports and Qualitative Research β Hashemi, Amirhossein (2023)
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π Cite this paper
Parnia, Sam, Spearpoint, Ken, de Vos, Gabriele, Fenwick, Peter, Goldberg, Diana, Yang, Jie, Zhu, Jiawen, Baker, Katie, Killingback, Hayley, McLean, Paula, Wood, Melanie, Zafari, A. Maziar, Dickert, Neal, Beisteiner, Roland, Sterz, Fritz, Berger, Michael, Warlow, Celia, Bullock, Siobhan, Lovett, Salli, McPara, Russell Metcalfe Smith, Marti-Navarette, Sandra, Cushing, Pam, Wills, Paul, Harris, Kayla, Sutton, Jenny, Walmsley, Anthony, Deakin, Charles D, Little, Paul, Farber, Mark, Greyson, Bruce, Schoenfeld, Elinor R (2014). AWARE--AWAreness during REsuscitation--A prospective study. Resuscitation. https://doi.org/10.1016/j.resuscitation.2014.09.004
@article{parnia_2014_aware,
title = {AWARE--AWAreness during REsuscitation--A prospective study},
author = {Parnia, Sam and Spearpoint, Ken and de Vos, Gabriele and Fenwick, Peter and Goldberg, Diana and Yang, Jie and Zhu, Jiawen and Baker, Katie and Killingback, Hayley and McLean, Paula and Wood, Melanie and Zafari, A. Maziar and Dickert, Neal and Beisteiner, Roland and Sterz, Fritz and Berger, Michael and Warlow, Celia and Bullock, Siobhan and Lovett, Salli and McPara, Russell Metcalfe Smith and Marti-Navarette, Sandra and Cushing, Pam and Wills, Paul and Harris, Kayla and Sutton, Jenny and Walmsley, Anthony and Deakin, Charles D and Little, Paul and Farber, Mark and Greyson, Bruce and Schoenfeld, Elinor R},
year = {2014},
journal = {Resuscitation},
doi = {10.1016/j.resuscitation.2014.09.004},
}