Induced coma

It is known as a coma induced to a state of profound unconsciousness through the administration of certain drugs . A medical procedure that is applied in those cases in which the patient has an injury that increases intracranial pressure. Thus, in induced coma the patient remains completely sedated, so that he does not respond to any type of stimulus.

What is induced coma?

Induced coma is a medical mechanism in which the patient is subjected to sedation with the main objective of reducing his consumption of both oxygen and energy. In this way, it seeks to protect the patient’s brain , thus giving it time to recover from the injuries.

Generally, the medical community decides to apply the induced comda when there is a high risk of developing a secondary lesion in the brain due to intracranial pressure . Swelling and inflammation are a natural response of the body during the healing process.

However, in the brain they can be harmful since excessive pressure can lead to certain areas of this organ not receiving the blood they need to function properly.

Thus, through induced coma , blood flow and brain activity are reduced , thereby achieving thinning of blood vessels. Consequently the inflammation and swelling decrease.

Once the doctors determine that the patient meets the necessary conditions to “come out” of the induced coma, they gradually withdraw the sedation. From that moment on, a series of neurological tests and examinations are carried out to check the sequelae. Short-term memory loss is a very common consequence of induced coma.

What good is the induced coma?

The main objective of this medical procedure is for the patient to remain unconscious for a certain period of time . This reduces pain and facilitates the application of other treatments, while allowing the brain to continue to function to maintain vital signs.

There are several reasons that can lead to subjecting a patient to an induced coma. One of the most common recurrences is a serious injury , resulting in increased intracranial pressure.

It is also common in a neurological operation , after which there is a certain risk that the patient’s brain does not receive the amount of oxygen it needs to function properly.

In the same way, the induced coma applies when the patient presents a disease of the respiratory system, such as pneumonia or severe pneumonia, that forces him to need an assisted breathing device.

And finally, this procedure can also be applied in those cases in which the patient’s physical pain is very great due to the injuries he suffers.

Causes of induced coma

There are a series of disorders, generally neurological, for which doctors sometimes decide to apply induced coma.

Stroke

Cerebral stroke is a disease characterized by the sudden obstruction of a blood vessel , or its rupture; on certain occasions both conditions may occur. Thus, depending on its origin, a difference is made between ischemic stroke (obstruction of a cerebral artery) or hemorrhagic stroke (bleeding from a cerebral artery). Today it is one of the leading causes of death and permanent disability among the adult population.

Some of the symptoms that warn of the situation are the following: sudden loss of strength on one side of the body, altered sensation, loss of vision, sudden difficulty in understanding language and severe headache.

Meningitis

It is known as meningitis the inflammation of the membranes surrounding the brain and spinal cord . It usually develops from a viral infection, although it can also be caused by bacteria or another microorganism.

The symptoms of meningitis are as follows: headache, elevated body temperature, and stiff neck. Given the appearance of these signs, it is important to urgently seek medical assistance.

Sepsis

The sepsis is a severe character disorder that occurs when the body responds in a way exaggerated to a particular bacterial infection . It occurs when chemicals released by the body result in widespread inflammation that decreases blood flow. As a result, the organs do not receive the nutrients and oxygen they need; a critical situation that can lead to septic shock.

Although everyone can develop sepsis, there are certain population groups in which this disease is more common. This is the case of babies, children and the elderly. Also sick with disorders such as diabetes , HIV or cancer.

Aneurysm

A cerebral aneurysm is the dilation in a certain blood vessel of this organ. There is a high risk of rupture, in which case bleeding occurs in the brain. A life threatening situation that requires immediate medical treatment.

Symptoms that indicate a ruptured aneurysm are: sudden headache, vomiting, stiff neck, seizures, loss of consciousness, and confusion.

Risks and consequences

The risks of this medical procedure are very high. It must be taken into account that medical coma applies when the physical and / or neurological condition of the patient is very serious. So far, despite the numerous studies that have been carried out on induced coma and its subsequent benefits, these remain unclear.

While it is true that while the patient remains in an induced coma he is unconscious and therefore does not suffer, the benefits in terms of his recovery have not been reliably demonstrated.

Sequelae of induced coma

Some of the most frequently occurring sequelae are motor in nature, such as partial or total paralysis of the body , as well as loss of strength and dexterity in the extremities .

Cognitive sequelae are also common in patients who have been in an induced coma for a long period of time; memory impairment, difficulty controlling impulses, or lack of control over language and swallowing.

How long can you stay in an induced coma?

One of the most common questions has to do with the length of time that you can remain in an induced coma. The truth is that there is no definitive answer since it depends in the first place on the cause that has led to the application of this procedure; and, second, of the patient’s own recovery.

In some cases the patient remains in an induced coma for a few days, while in others the situation can last for several months.

Awakening from induced coma

The chances of waking up from an induced coma are greater than those of a patient who has fallen into a coma . The reason is that in this case it is a treatment determined by doctors, in which the coma is applied artificially.

The chances of awakening from the induced coma vary depending on how long the patient has been in that state. Recent research indicates that the stipulated time for the probability of recovery both physically and mentally to be practically 100%, should not elapse more than two weeks.

Meanwhile, when the induced coma lasts longer than thirty days, the chances of recovery are reduced to 18%. In those cases in which the period exceeds four months, it is almost assumed that there will be numerous sequelae, some of a serious nature, due to the fact that the brain has been inactive for a long time.

Process

Once the patient wakes up from having spent a certain period of time in an induced coma, their interaction with the environment is not at all immediate. It is an important factor that both the relatives of the patient in question must take into consideration.

The reaction is a gradual process that can last more or less time depending on the severity of the injury, as well as the time that your brain has been in a state of unconsciousness, and the consequences.

Time it takes to wake up from an induced coma

Once physicians remove drug sedation, not all patients awaken from induced coma within minutes. What’s more, in some cases it can take several hours, or even days.

There are several factors that determine in some way the recovery time, the following being the most relevant. On the one hand, the time that the patient has remained in an induced coma ; As we have pointed out, the longer the period of brain inactivity , the more likely it is that some of the brain’s functions will be affected.

On the other hand, the intensity of sedation itself , which varies depending on the injury presented by the patient and his physical and neurological state. Also, the age of the patient; generally, it is adults and young people who have a faster recovery period.

And finally, the severity of the injury that led to this procedure.

Induced coma and sedation

There are those who take both medical procedures synonymously, but they are completely different. In the case of induced coma, the patient is subjected to a state of profound unconsciousness. Meanwhile, in sedation, he remains in a state of semi-unconsciousness so that the patient remains as comfortable as possible during a surgical intervention.

Sedation is administered through an intravenous catheter and its side effects are minimal. On the contrary, induced coma can only be applied in the intensive care units of medical centers and, in a high percentage of cases, it gives rise to a series of sequelae.

Conclution

By way of conclusion, it is important to note that the neurological sequelae of induced coma can be severe . That is why in no case is its application recommended randomly. It should only be done when strictly necessary; that is, when a brain injury results in an increase in intracranial pressure .

During this procedure, the brain “goes to sleep”, while its activity remains monitored at all times. This protects the brain and gives the body a period of time to recover.