“Although for decades scientists believed the brain dies within 10 minutes of oxygen deprivation, recent scientific advances have proven this incorrect,” Parnia tells Newsmax. “Instead, after death, the oxygen-deprived brain and body go through a hibernation-like state for many hours longer. This means that for people who are otherwise healthy, such as those who are victims of accidents, shootings, or sudden cardiac arrests, death should be understood as a medically treatable event ─ like a stroke — for many hours after it has taken place.”
Parnia, associate professor of medicine at New York University’s Langone Medical Center, has been studying end-of-life phenomena for over 30 years and reveals his eye-opening research in his new book.
He questions when life ends, and when death begins, adding that while we’ve made major breakthroughs in the fields of treatment for cancer, cardiovascular disease and other ailments, our progress in treating death has been stagnant.
“What we believe about death is fundamentally wrong,” says Parina. It is not the end, he says, but a “reversible state.”
According to Yahoo.com, Parnia says that seeing a flatline on an electrocardiogram (EKG) ─ a measure of the electrical impulses of the heart ─ is not necessarily a death sentence. Recent evidence backs this up.
Researchers at Yale University successfully revived decapitated pig brains up to 14 hours post-mortem in 2019. In 2022, Yale scientists showed how a modified heart and lung machine combined with drugs restored organs in pigs. “It is just a matter of time,” suggests Parnia, that these results can be translated to humans.
There are also stories about how people have been revived after their hearts stopped for hours because they were in freezing temperatures that somehow preserved the organ. Thanks to a machine called an ECMO (extracorporeal membrane oxygenation), which serves as an artificial heart and lung, these patients survived. Parnia says that cooling the body is highly protective.
In a study published last year, researchers found that in patients who survived cardiac arrest, nearly 40% had brain activity that returned to normal, or nearly normal, even an hour into CPR. An electroencephalogram (EEG) captured the brain activity with electrodes, according to NYU Langone Health. These patients later had clear memories of experiencing death and while unconscious, had brain patterns linked to thought and memory.
“This is the first large study to show that these recollections and brain wave changes may be signs of universal, shared elements of so-called near-death experiences,” said Parnia, who was senior author of that study.
The expert says that we need to revise our thinking and methods of reviving patients. CPR, introduced in 1959, has a paltry 10% success rate and many hospitals now have ECMO machines that are far superior. He acknowledges that not every patient can be brought back from the dead. People with multiple organ failure are unlikely candidates. But others, like himself at age 52, do not have to stay dead.
“I tell everyone, look, I’m going to have a cardiac arrest soon. And I am appalled at the treatment I’m going to get. If I have a heart attack tomorrow, why should I stay dead? That’s not necessary anymore. I have little doubt that, in the future, people who would be declared dead today will routinely be brought back to life.”
https://www.newsmax.com/health/health-news/death-reversible-revive/2024/08/28/id/1178199/
Parnia S. Death and consciousness--an overview of the mental and cognitive experience of death. Ann N Y Acad Sci. 2014 Nov;1330:75-93. doi: 10.1111/nyas.12582. PMID: 25418460.
Parnia S. Death and consciousness--an overview of the mental and cognitive experience of death. Ann N Y Acad Sci. 2014 Nov;1330:75-93. doi: 10.1111/nyas.12582. PMID: 25418460.
Abstract
Advances in resuscitation science have indicated that, contrary to perception, death by cardiorespiratory criteria can no longer be considered a specific moment but rather a potentially reversible process that occurs after any severe illness or accident causes the heart, lungs, and brain to stop functioning. The resultant loss of vital signs of life (and life processes) is used to declare a specific time of death by physicians globally. When medical attempts are made to reverse this process, it is commonly referred to as cardiac arrest; however, when these attempts do not succeed or when attempts are not made, it is called death by cardiorespiratory criteria. Thus, biologically speaking, cardiac arrest and death by cardiorespiratory criteria are synonymous. While resuscitation science has provided novel opportunities to reverse death by cardiorespiratory criteria and treat the potentially devastating consequences of the resultant postresuscitation syndrome, it has also inadvertently provided intriguing insights into the likely mental and cognitive experience of death. Recollections reported by millions of people in relation to death, so-called out-of-body experiences (OBEs) or near-death experiences (NDEs), are often-discussed phenomena that are frequently considered hallucinatory or illusory in nature; however, objective studies on these experiences are limited. To date, many consistent themes corresponding to the likely experience of death have emerged, and studies have indicated that the scientifically imprecise terms of NDE and OBE may not be sufficient to describe the actual experience of death. While much remains to be discovered, the recalled experience surrounding death merits a genuine scientific investigation without prejudice.
Parnia S, Keshavarz Shirazi T, Patel J, Tran L, Sinha N, O'Neill C, Roellke E, Mengotto A, Findlay S, McBrine M, Spiegel R, Tarpey T, Huppert E, Jaffe I, Gonzales AM, Xu J, Koopman E, Perkins GD, Vuylsteke A, Bloom BM, Jarman H, Nam Tong H, Chan L, Lyaker M, Thomas M, Velchev V, Cairns CB, Sharma R, Kulstad E, Scherer E, O'Keeffe T, Foroozesh M, Abe O, Ogedegbe C, Girgis A, Pradhan D, Deakin CD. AWAreness during REsuscitation - II: A multi-center study of consciousness and awareness in cardiac arrest. Resuscitation. 2023 Oct;191:109903. doi: 10.1016/j.resuscitation.2023.109903. Epub 2023 Jul 7. PMID: 37423492.
Abstract
Introduction: Cognitive activity and awareness during cardiac arrest (CA) are reported but ill understood. This first of a kind study examined consciousness and its underlying electrocortical biomarkers during cardiopulmonary resuscitation (CPR).
Methods: In a prospective 25-site in-hospital study, we incorporated a) independent audiovisual testing of awareness, including explicit and implicit learning using a computer and headphones, with b) continuous real-time electroencephalography(EEG) and cerebral oxygenation(rSO2) monitoring into CPR during in-hospital CA (IHCA). Survivors underwent interviews to examine for recall of awareness and cognitive experiences. A complementary cross-sectional community CA study provided added insights regarding survivors' experiences.
Results: Of 567 IHCA, 53(9.3%) survived, 28 of these (52.8%) completed interviews, and 11(39.3%) reported CA memories/perceptions suggestive of consciousness. Four categories of experiences emerged: 1) emergence from coma during CPR (CPR-induced consciousness [CPRIC]) 2/28(7.1%), or 2) in the post-resuscitation period 2/28(7.1%), 3) dream-like experiences 3/28(10.7%), 4) transcendent recalled experience of death (RED) 6/28(21.4%). In the cross-sectional arm, 126 community CA survivors' experiences reinforced these categories and identified another: delusions (misattribution of medical events). Low survival limited the ability to examine for implicit learning. Nobody identified the visual image, 1/28(3.5%) identified the auditory stimulus. Despite marked cerebral ischemia (Mean rSO2 = 43%) normal EEG activity (delta, theta and alpha) consistent with consciousness emerged as long as 35-60 minutes into CPR.
Conclusions: Consciousness. awareness and cognitive processes may occur during CA. The emergence of normal EEG may reflect a resumption of a network-level of cognitive activity, and a biomarker of consciousness, lucidity and RED (authentic "near-death" experiences).
West RL, Otto Q, Drennan IR, Rudd S, Böttiger BW, Parnia S, Soar J. CPR-related cognitive activity, consciousness, awareness and recall, and its management: A scoping review. Resusc Plus. 2022 May 9;10:100241. doi: 10.1016/j.resplu.2022.100241. PMID: 35586308; PMCID: PMC9108988.
Abstract
Background: There are increasing numbers of reports of cognitive activity, consciousness, awareness and recall related to cardiopulmonary resuscitation (CPR) and interventions such as the use of sedative and analgesic drugs during CPR.
Objectives: This scoping review aims to describe the available evidence concerning CPR-related cognitive activity, consciousness, awareness and recall and interventions such as the use of sedative and analgesic drugs during CPR.
Methods: A literature search was conducted of Medline, Embase and CINAHL from inception to 21 October 2021. We included case studies, observational studies, review studies and grey literature.
Results: We identified 8 observational studies including 40,317 patients and 464 rescuers, and 26 case reports including 33 patients. The reported prevalence of CPR-induced consciousness was between 0.23% to 0.9% of resuscitation attempts, with 48-59% of experienced professional rescuers surveyed estimated to have observed CPR-induced consciousness. CPR-induced consciousness is associated with professional rescuer CPR, witnessed arrest, a shockable rhythm, increased return of spontaneous circulation (ROSC), and survival to hospital discharge when compared to patients without CPR-induced consciousness. Few studies of sedation for CPR-induced consciousness were identified. Although local protocols for treating CPR-induced consciousness exist, there is no widely accepted guidance.
Conclusions: CPR-related cognitive activity, consciousness, awareness and recall is uncommon but increasingly reported by professional rescuers. The data available was heterogeneous in nature and not suitable for progression to a systematic review process. Although local treatment protocols exist for management of CPR-induced consciousness, there are no widely accepted treatment guidelines. More studies are required to investigate the management of CPR-induced consciousness.
Keywords: ALS, Advanced life support; Awareness; CPR, Cardiorespiratory resuscitation; Cardiac arrest; Cardiopulmonary resuscitation; Consciousness; ED, Emergency Department; EMS, Emergency medical service; GCS, Glasgow coma scale; ICU, Intensive care unit; IHCA, In-hospital cardiac arrest; ILCOR, International Liaison Committee on Resuscitation; Near death experience; OHCA, Out-of-hospital cardiac arrest; OR, Odds Ratio; PTSD, Post-traumatic stress disorder; Post-traumatic stress disorder; ROSC, Return of spontaneous circulation; VF, Ventricular fibrillation; VT, Ventricular tachycardia; pVT, pulseless ventricular tachycardia.
Parnia S, Post SG, Lee MT, Lyubomirsky S, Aufderheide TP, Deakin CD, Greyson B, Long J, Gonzales AM, Huppert EL, Dickinson A, Mayer S, Locicero B, Levin J, Bossis A, Worthington E, Fenwick P, Shirazi TK. Guidelines and standards for the study of death and recalled experiences of death--a multidisciplinary consensus statement and proposed future directions. Ann N Y Acad Sci. 2022 May;1511(1):5-21. doi: 10.1111/nyas.14740. Epub 2022 Feb 18. PMID: 35181885.
Abstract
An inadvertent consequence of advances in stem cell research, neuroscience, and resuscitation science has been to enable scientific insights regarding what happens to the human brain in relation to death. The scientific exploration of death is in large part possible due to the recognition that brain cells are more resilient to the effects of anoxia than assumed. Hence, brain cells become irreversibly damaged and "die" over hours to days postmortem. Resuscitation science has enabled life to be restored to millions of people after their hearts had stopped. These survivors have described a unique set of recollections in relation to death that appear universal. We review the literature, with a focus on death, the recalled experiences in relation to cardiac arrest, post-intensive care syndrome, and related phenomena that provide insights into potential mechanisms, ethical implications, and methodologic considerations for systematic investigation. We also identify issues and controversies related to the study of consciousness and the recalled experience of cardiac arrest and death in subjects who have been in a coma, with a view to standardize and facilitate future research.
Keywords: cardiac arrest; cardiopulmonary resuscitation-induced consciousness (CPRIC); death; death by brain death criteria; external visual awareness (EVA); near-death experiences (NDEs); out-of-body experiences (OBEs); post-intensive care syndrome (PICS); recalled experience of death (RED) coma; resuscitation.
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