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AWARE--AWAreness during REsuscitation--A prospective study

πŸ“„ Original study β†—
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 β€’ 2014 Modern Era β€’ nde

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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 46% reported some kind of mental experience during the time they were clinically dead. About 9% had what matched the classic definition of a near-death experience (think tunnels of light and life reviews), and 2% 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.

Actual Paper 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.

Research Notes

The largest prospective study of awareness during cardiac arrest, extending van Lommel et al. (2001) with more participants across three countries. Central to the NDE-consciousness survival debate, providing one verified case of awareness when brain function should have been absent. Led to the larger AWARE II follow-up study.

A four-year multicenter observational study across 15 US, UK, and Austrian hospitals examined the incidence and nature of cognitive experiences during cardiac arrest (CA). Of 2060 CA events, 140 survivors completed initial interviews and 101 completed detailed follow-ups using a three-stage quantitative and qualitative interview system. Results showed 46% had memories during CA with seven major cognitive themes, 9% had experiences compatible with NDEs on the Greyson Scale, and 2% described full awareness with explicit recall of seeing and hearing resuscitation events. One patient demonstrated verified conscious awareness for approximately 3 minutes during a period when cerebral function was not expected, accurately describing specific details confirmed by medical staff.

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πŸ“‹ Cite this paper
APA
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
BibTeX
@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},
}