Return of spontaneous circulation

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Return of spontaneous circulation (ROSC) is resumption of sustained perfusing cardiac activity associated with significant respiratory effort after cardiac arrest.[1] Signs of ROSC include breathing, coughing, or movement and a palpable pulse or a measurable blood pressure. Cardiopulmonary resuscitation and defibrillation increase the chances of ROSC.[1]

The return of circulation, while a good thing and a favorable short-term indicator, is not on its own a predictor of a favorable medium- or long-term outcome. Patients have died not long after their circulation has returned.

Lazarus phenomenon or autoresuscitation after failed cardiopulmonary resuscitation is the spontaneous return of circulation after resuscitation attempts have stopped in someone with cardiac arrest.[2][3] Thus passive monitoring is recommended for 10 minutes after resuscitation attempts have stopped.[2]


  1. ^ a b Jacobs I, Nadkarni V, Bahr J, et al. (November 2004). "Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Councils of Southern Africa)". Circulation. 110 (21): 3385–97. doi:10.1161/01.CIR.0000147236.85306.15. PMID 15557386.
  2. ^ a b Wiese CH, Bartels UE, Orso S, Graf BM (April 2010). "[Lazarus phenomenon. Spontaneous return of circulation after cardiac arrest and cessation of resuscitation attempts]". Anaesthesist (in German). 59 (4): 333–41. doi:10.1007/s00101-010-1709-7. PMID 20224948.
  3. ^ Hornby K, Hornby L, Shemie SD (May 2010). "A systematic review of autoresuscitation after cardiac arrest". Crit. Care Med. 38 (5): 1246–53. doi:10.1097/CCM.0b013e3181d8caaa. PMID 20228683.