Artificial coma to protect the body

Artificial coma as a life-saving measure

31.12.2013

A natural coma (long-term unconsciousness) can occur as a result of severe skull injuries as well as various brain diseases, certain metabolic disorders and poisoning. Those affected can not be woken up and remain partially in this state of unconsciousness for months or even years. The coma probably fulfills a protective function, especially in situations in which pain occurs that a person would normally not be able to withstand, according to the current state of medical knowledge. However, it remains unclear when exactly patients fall into a coma or which processes are underlying this.

In medicine, the artificial coma is used to treat the pain and facilitate the treatment of patients after serious injury or extensive surgery. In fact, however, the term coma is rather misleading here, since those affected only receive a long-lasting general anesthetic, but theoretically could be brought back from the artificial coma at any time. In real coma, this possibility does not exist. As a rule, patients do not wake up until their condition has improved significantly. Although laymen can not detect differences between the various forms of comatose unconsciousness, physicians distinguish different degrees of severity here. These are subdivided by the reaction to pain stimuli, the pupil or eye movement and certain reflexes.

Brain trauma often causes coma
Possible causes of a coma are especially injuries and brain diseases. Many patients with severe traumatic brain injury (possibly accompanied by cerebral hemorrhage) temporarily go into coma. But also an inflammation in the brain (encephalitis) or the meninges (meningitis), a stroke, heart attack or a brain tumor can trigger the coma. There are also metabolic disorders such as an extreme derailment of blood sugar levels (significantly lower or too high blood sugar) and intoxications (poisoning). If the causes of the coma can be remedied by therapeutic means, the affected persons usually regain their consciousness, but under certain circumstances, consequential damage and corresponding deficiency symptoms can be observed.

Artificial coma is used for treatment
In the case of artificial coma, pain sensation and consciousness are eliminated by medication, in order to facilitate the treatment and relieve the body. There is an artificial respiration and intensive monitoring of bodily functions. The affected persons are fed via a nasogastric tube or by infusion solutions. The artificial coma protects the brain and the high dosage of painkillers and sleeping pills can contribute to a regulation of the disturbed pressure conditions in the brain, explained Manfred Westphal from the University Medical Center Hamburg-Eppendorf „Hamburger Abendblatt“ the benefits of such a procedure. „If there is any bleeding or swelling that presses on the brain, the brain needs to be relieved. This can be done by decongestants and by the artificial coma“, stressed the doctor. The body temperature of patients is sometimes lowered to 32 to 35 degrees to slow down the metabolism of the body and reduce the oxygen consumption, as this also contributes to the relief of the brain.

Relief of the brain in case of injuries
According to the expert, the artificial coma also has the advantage that the patient's circulation stabilizes. Because with severe brain injuries lead the high adrenaline output to an additional burden. The organism shows a classic stress response (accelerated heart rate, increased blood pressure, etc.), which may adversely affect the condition of the patient. Therefore, the affected persons are kept in an artificial coma until possible edema and bleeding in the brain subsided and, from a medical point of view, no disadvantages are expected when waking up. When the time comes, the anesthetics are reduced and the affected people regain consciousness. (Fp)