AWAreness during REsuscitation - II: A Multi-Center Study of Consciousness and Awareness in Cardiac Arrest
📄 Original study ↗📌 Appears in:
Plain English Summary
This is the biggest study ever to monitor what happens in people's brains during cardiac arrest — when the heart stops and you're technically dying. Researchers wired up patients at 25 hospitals with brain-wave monitors and even placed hidden visual targets near the ceiling to test whether out-of-body experiences are real. The results are a fascinating mixed bag. Nearly 40% of survivors who were interviewed reported some form of awareness — from dreamlike states to profound 'experiences of death.' Here's the jaw-dropping part: even after severe oxygen deprivation, normal brain activity patterns linked to consciousness popped up 35 to 60 minutes into CPR, way longer than anyone expected a dying brain to keep working. However, nobody spotted those hidden ceiling targets, and almost none of the people reporting rich experiences happened to have usable brain data recorded. COVID-19 cut the study short, leaving tantalizing but incomplete evidence that consciousness during cardiac arrest is more common — and more mysterious — than we thought.
Research Notes
The largest prospective study of consciousness during cardiac arrest with concurrent brain monitoring, and the direct sequel to AWARE I. While EEG findings suggest cortical activity persists longer than expected, the hidden-target paradigm failed to produce positive results, and only 2 of 28 interviewed survivors had EEG data — neither among those reporting NDEs. Study terminated early by COVID-19. Central to Controversy #7. PDF needs re-downloading (original file contained wrong paper).
Cognitive activity during cardiac arrest (CA) was examined in a prospective 25-site study across US and UK hospitals (May 2017-March 2020). Independent audiovisual awareness testing and continuous real-time EEG and cerebral oxygenation (rSO2) monitoring were incorporated into CPR during in-hospital CA. Of 567 IHCA, 53 survived (9.3%); 28 completed interviews and 11 (39.3%) reported memories suggestive of consciousness. Four experience categories emerged: CPR-induced consciousness (7.1%), post-resuscitation awareness (7.1%), dream-like states (10.7%), and transcendent recalled experiences of death (21.4%). Despite marked cerebral ischemia (mean rSO2=43%), normal EEG activity (delta, theta, alpha) consistent with consciousness emerged 35-60 minutes into CPR. No survivor identified hidden visual targets; one showed inconclusive implicit auditory recall.
Links
Related Papers
Cites
- Near-Death Experience in Survivors of Cardiac Arrest: A Prospective Study in the Netherlands — van Lommel, Pim (2001)
- Incidence and Correlates of Near-Death Experiences in a Cardiac Care Unit — Greyson, Bruce (2003)
- The Near-Death Experience Scale: Construction, Reliability, and Validity — Greyson, Bruce (1983)
- Surge of neurophysiological coherence and connectivity in the dying brain — Borjigin, Jimo (2013)
Companion
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📋 Cite this paper
Parnia, Sam, Keshavarz Shirazi, Tara, Patel, Jignesh, Tran, Linh, Sinha, Niraj, O'Neill, Caitlin, Roellke, Emma, Mengotto, Amanda, Findlay, Shannon, McBrine, Michael, Spiegel, Rebecca, Tarpey, Thaddeus, Huppert, Elise, Jaffe, Ian, Gonzales, Anelly M, Xu, Jing, Koopman, Emmeline, Perkins, Gavin D, Vuylsteke, Alain, Bloom, Benjamin M, Jarman, Heather, Tong, Hiu Nam, Chan, Louisa, Lyaker, Michael, Thomas, Matthew, Velchev, Veselin, Cairns, Charles B, Sharma, Rahul, Kulstad, Erik, Scherer, Elizabeth, O'Keeffe, Terence, Foroozesh, Mahtab, Abe, Olumayowa, Ogedegbe, Chinwe, Girgis, Amira, Pradhan, Deepak, Deakin, Charles D (2023). AWAreness during REsuscitation - II: A Multi-Center Study of Consciousness and Awareness in Cardiac Arrest. Resuscitation. https://doi.org/10.1016/j.resuscitation.2023.109903
@article{parnia_2023_aware_ii,
title = {AWAreness during REsuscitation - II: A Multi-Center Study of Consciousness and Awareness in Cardiac Arrest},
author = {Parnia, Sam and Keshavarz Shirazi, Tara and Patel, Jignesh and Tran, Linh and Sinha, Niraj and O'Neill, Caitlin and Roellke, Emma and Mengotto, Amanda and Findlay, Shannon and McBrine, Michael and Spiegel, Rebecca and Tarpey, Thaddeus and Huppert, Elise and Jaffe, Ian and Gonzales, Anelly M and Xu, Jing and Koopman, Emmeline and Perkins, Gavin D and Vuylsteke, Alain and Bloom, Benjamin M and Jarman, Heather and Tong, Hiu Nam and Chan, Louisa and Lyaker, Michael and Thomas, Matthew and Velchev, Veselin and Cairns, Charles B and Sharma, Rahul and Kulstad, Erik and Scherer, Elizabeth and O'Keeffe, Terence and Foroozesh, Mahtab and Abe, Olumayowa and Ogedegbe, Chinwe and Girgis, Amira and Pradhan, Deepak and Deakin, Charles D},
year = {2023},
journal = {Resuscitation},
doi = {10.1016/j.resuscitation.2023.109903},
}