Hennepin County District Judge Fred Karasov has been on life support since he went into cardiac arrest early last month and faces an uncertain prognosis.

Karasov is no longer in a coma, but he has not responded to commands or spoken since he collapsed a month ago. He has been moved to a long-term care facility and uses breathing and feeding tubes, according to a post by his brother, Dr. Robert Karasov, on the CaringBridge website.

The judge’s absence and his condition has hit officials and staffers hard at the Hennepin County courthouse, where he is universally liked for his playful personality, intelligence and integrity.

“He’s aware of his surroundings but it’s hard to know what he’s comprehending,” said Robert Karasov, a physician, in an interview late Wednesday. “There’s always hope, but the longer this goes on, the less hope there is.”

Encouraging words have rolled in from the county prosecutor’s office, where Karasov once worked, and from criminal defense attorneys, among others.

Karasov, who has always led an active lifestyle and was preparing for a vacation to Croatia, was working out Sept. 7 at an Orangetheory Fitness club when his heart stopped.

A physician and a nurse immediately began CPR, and paramedics within minutes restarted his heart with a shot of epinephrine and one electrical shock, according to his brother’s CaringBridge posts.

At HCMC, doctors found the main artery to Karasov’s heart almost completely blocked and inserted a stent, his brother wrote. The judge was put in a medically induced coma to keep him cool and minimize brain damage.

Visitors have streamed into the hospital and care center, Robert Karasov said. The “tremendous outpouring of love and support” and hearing from so many people who felt close to the judge has been heartwarming to the family, he wrote.

“The main message is: We are praying for a recovery but it’s a tough situation,” his brother said. “We’re trying to give him every opportunity to make as full a recovery as he can.”

In his absence on the bench, Karasov’s caseload is being handled by Judge Paul Scoggin, according to a court spokesman.

Karasov was an assistant Hennepin County attorney, mostly in the criminal division, from 1982 until 2008 when Gov. Tim Pawlenty appointed him to the bench. Since 1988, he also has been a judge advocate general (JAG) in the Minnesota Army National Guard.

Eleven months after he was named to the bench, Karasov was sent on a seven-month deployment to Iraq with the National Guard’s 34th Red Bull Infantry Division.

“On one hand, I’m proud to serve and I’m proud to go,” Karasov told the Star Tribune. “On the other hand, the timing wasn’t so good. Here I am, I’ve been on the job less than a year.”

In the courtroom, Karasov’s style is calm and respectful. He doesn’t require his clerk to call spectators to their feet when he enters, usually slipping in quietly from his chambers.

In 2009, Karasov said he loved being a prosecutor but thought he could have more of an impact as a judge.

“I figured thousands of people will come into my courtroom … and the way I conduct myself and the way I run my courtroom can greatly influence the way people see our system,” he said.