Brain Activity During CPR in AWARE II
More data from AWARE II. Eduardo picked this one up. This is also being presented at the AHA meeting this weekend, and while not as exciting from the NDE side of things, is very important because it appears to slay one of our holy cows…people cannot be conscious if they have had a CA.
As with abstract 387, the significance of this abstract needs teasing out (and after my last effort, please let me know if I have misunderstood it again!). It has to be said that this one is written using even more jargon. In this “experiment” 38 patients from AWARE II had simultaneous measurement of EEG and brain oxygenation during CPR. CPR lasted for between 10-60 minutes, and the correlation between brain oxygen levels and EEG was established. Various levels of brain activity were defined: normal/near normal, seizures, coma, absence of cortical activity, as determined by EEG. rSO2 (cerebral oximetry levels) of 60-80% are normally required for normal brain function, including consciousness. However, this study suggests that levels as low as 30% are sufficient to produce cortical activity and that these levels are achieved at various points during CPR. From the conclusions:
…real-time bimodal brain monitoring provides insights regarding brain resuscitation and its dynamic interaction with patient factors. While ischemia may cause epileptogenic activity, there are periods of normal/near-normal cortical activity despite prolonged CPR >45-60 mins. A minimal threshold of brain oxygen delivery (rSO2>30%) may be required for cortical activity. These data raise questions regarding assumptions of irreversible brain damage with prolonged CPR, as well as the possibility of consciousness and cognitive activity during CPR
This, to me, at least suggests that periods of consciousness are possible during CPR after a CA and before full ROSC (return of spontaneous circulation) is achieved. This is food for skeptics who will now claim that NDEs are a result of these kinds of brain activity. However, unless one of the NDEs in abstract 287 is directly correlated with rSO2 levels>30%, then these findings are irrelevant to NDEs. There is no mention of matching the patients in the two posters. What I would hope would be to see the subject who heard the noise from the headphones have an rSO2 of >30%, but the other 4 below those levels.
It would be good to have the whole poster or presentations for these. they may be available after they have been presented.