Is it truly possible for people to be revived from death after experiencing no heartbeat for several minutes or even hours? (Image credit: Halfpoint Images via Getty Images)
Frequently, death is irreversible — the chances of someone’s heart restarting after it ceases to beat are very slim. However, in some instances, emergency personnel can aid in resurrecting someone from death, even after their heart has stopped.
Therefore, what is the longest duration a person can be clinically deceased and then be brought back to life?
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To grasp how this transpires, it’s crucial to first establish a precise understanding of death.
“In most instances when [physicians] mention ‘clinically dead,’ we’re referring to cardiac death, signifying the cessation of the heart’s pumping action,” stated Dr. Daniel Mark Rolston, an emergency medicine doctor at Northwell Health in New York, in an interview with Live Science.
When the heartbeat ceases, every cell in the body — particularly those in the brain — no longer receives a continuous flow of freshly oxygenated blood. If cells are without oxygen for approximately five minutes, they start to perish, an irreversible process.
Another form of clinical death is brain death, which develops when the brain sustains such extensive damage that it loses its capability to regulate fundamental bodily operations, like breathing and heartbeat.
How resuscitation functions
Cardiopulmonary resuscitation (CPR) aims to sustain the circulation of fresh blood throughout the body and preserve the life of brain cells in the aftermath of cardiac death. By physically compressing the chest and performing rescue breaths, emergency responders can aid in maintaining cell oxygenation for a brief span, even if the heart doesn’t beat spontaneously. Generally, CPR isn’t able to reignite the heart on its own, but it provides a window for alternative methods that can.
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To stimulate the heart to resume its natural rhythm, emergency responders employ a technique referred to as defibrillation. This entails administering an external electrical shock to the heart, imitating the inherent electrical impulses that the heart muscles utilize to contract. Occasionally, these electrical signals can reset the heart and assist it in resuming its rhythmic pumping.
When conditions are optimal, these life-sustaining methods can achieve fairly good success rates. The American Red Cross suggests that the success rate following CPR within a hospital is roughly 20%. These figures decrease when individuals experience cardiac arrest beyond the confines of a healthcare setting, falling to approximately 10%. This stems from the scarcity of CPR-trained individuals and the slower response times beyond healthcare environments.
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“The sooner you receive it, the more promising the outcomes,” Rolston clarified.
However, resuscitation achieving success after a duration surpassing half an hour is rare, even when CPR is consistently administered.
“For the overwhelming majority of individuals enduring extended periods of cardiac arrest, the odds of survival are significantly reduced,” Rolston noted. “If a person is not revived within the 30-minute mark, their likelihood of survival diminishes substantially.”
Success rates in resuscitation are elevated among individuals who suffer cardiac arrest while concurrently experiencing diminished body temperatures. Utilizing hypothermia to extend time
Nevertheless, there is a remarkable exception to this general principle: circumstances where cardiac arrest occurs in conjunction with hypothermia. Hypothermia is identified when the core body temperature descends beneath 95 degrees Fahrenheit (35 degrees Celsius); it is inherently perilous, potentially precipitating the failure of the heart and lungs, ultimately culminating in death.
Conversely, if the heart has already ceased its functionality, hypothermia can, surprisingly, exhibit some advantageous attributes. Low temperatures lead to a deceleration of the body’s metabolic rate, thereby shielding the delicate cells within the brain from demise upon exhausting their oxygen reserves.
“When subjected to rapid cooling, it can furnish prolonged protection,” Dr. Samuel Tisherman, a professor of surgery at the University of Maryland School of Medicine and an investigator into the application of hypothermia as a therapeutic intervention in instances of cardiac arrest attributed to trauma, elaborated. “Numerous cases have been documented of individuals succumbing to drowning in frigid waters, spending over an hour submerged, and yet managing to survive.”
The most protracted instance documented of successful resuscitation following cardiac arrest and inadvertent hypothermia pertains to a 31-year-old male who was revived after a period of eight hours and 42 minutes. The individual, whose body temperature was already around 79 F (26 C) owing to a summer storm, underwent cardiac arrest, prompting immediate CPR administration from nearby individuals, sustained for over three and a half hours. Upon admittance to a medical facility, the man was situated on a life support system, ensuring continuous blood circulation for a five-hour duration; subsequently, he was gradually warmed and successfully resuscitated. After a three-month period, physicians communicated the man’s complete recovery, without any enduring neurological damage.
What about revival following brain death?
While recovery routes from cardiac arrest exist, brain death presents an entirely different scenario. When a patient is pronounced brain dead, it signifies that their brain is incapable of dispatching the signals vital for controlling fundamental bodily functions.
To formally declare brain death, medical practitioners must ascertain the root medical condition responsible for the brain damage and dismiss any conditions presenting symptoms suggestive of brain death. This can entail brain imaging through MRI, assessments of core neurological reflexes, like pupillary responses, and confirmation of the patient’s capacity for independent breathing.
Occasionally, news reports circulate regarding patients initially pronounced brain dead and taken off life support, only to later “come back to life.” Does this mean these patients are truly arising from death?
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In all probability, no. The definition of brain death implies irreparable damage to vital regions of the brain, thus, brain death isn’t a reversible condition. When an individual seemingly recuperates from brain death, it is likely that the original diagnosis was inaccurate.
“Instances of errors have surfaced wherein patients deemed brain dead subsequently displayed unexpected spontaneous movement,” Dr. Robert M. Sade, a professor of surgery at the Medical University of South Carolina, conveyed to Medscape in 2018. “In almost all of these instances, the determination of brain death was executed incorrectly.”
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Marilyn PerkinsContent Manager
Marilyn Perkins acts as the content director at Live Science. Based in Los Angeles, California, she functions as a science author and artist. Her science writing master’s originates from Johns Hopkins, complementing her neuroscience bachelor’s from Pomona College. New Scientist, the Johns Hopkins Bloomberg School of Public Health magazine, and Penn Today have all showcased her work. Further, she garnered the 2024 National Association of Science Writers Excellence in Institutional Writing Award for short-form pieces.
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