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Artificial coma as a life-saving measure
A natural coma (long-term loss of consciousness) can occur as a result of severe skull injuries as well as various brain diseases, certain metabolic disorders and poisoning. Those affected cannot be woken up and sometimes remain 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 humans would normally not be able to endure, according to medical knowledge to date. However, it has so far remained unclear exactly when patients fall into a coma or which processes are at the basis of this.
In medicine, the artificial coma is used to relieve pain after serious injuries or during extensive operations and to facilitate treatment. In fact, the term coma is rather misleading here, since those affected only receive long-term general anesthesia, but could theoretically be removed from the artificial coma at any time. However, this possibility does not exist in real coma. Here, patients usually only wake up when their condition has improved significantly. Even though laypeople cannot find any differences between the various forms of comatose loss of consciousness, doctors distinguish between different degrees of severity. These are subdivided based on the reaction to pain stimuli, the pupil or eye movement and certain reflexes.
Brain trauma is often the cause of coma Possible causes of a coma are in particular injuries and diseases of the brain. Many patients with severe traumatic brain injuries (possibly accompanied by bleeding from the brain) temporarily go into a coma. Inflammation in the brain (encephalitis) or the meninges (meningitis), a stroke, heart attack or a brain tumor can also trigger the coma. In addition, there are metabolic disorders such as extreme derailment of the blood sugar level (blood sugar is too low or too high) and intoxications (poisoning). If the causes of the coma can be remedied therapeutically, those affected usually regain consciousness, however, consequential damage and corresponding signs of failure may be observed.
Artificial coma is used for treatment In artificial coma, the sensation of pain and consciousness are switched off by medication in order to facilitate treatment and relieve the body. There is artificial ventilation and intensive monitoring of body functions. Those affected are fed using a gastric tube or infusion solutions. The artificial coma protects the brain and the high dosage of painkillers and sleeping pills can help regulate the disturbed pressure conditions in the brain, Manfred Westphal from the University Clinic Hamburg-Eppendorf explained to the "Hamburger Abendblatt" the advantages of such a procedure. “If there is bleeding or swelling that presses on the brain, the brain has to be relieved. This can be done with decongestant medication and through an artificial coma, ”emphasized the doctor. The body temperature of the patient is sometimes lowered to 32 to 35 degrees in order to slow down the body's metabolism and reduce oxygen consumption, since this also helps to relieve the brain.
Relief of the brain in the event of injuries According to the expert, the artificial coma also has the advantage that the patient's circulation stabilizes. Because with severe brain injuries, the high adrenaline output leads to an additional burden. The organism shows a classic stress reaction (accelerated heart rate, increased blood pressure etc.), which can have an unfavorable effect on the patient's condition. Therefore, those affected are kept in an artificial coma until possible edema and bleeding in the brain have subsided and, from a medical point of view, no further disadvantages are to be expected when waking up. When the time has come, the anesthetics are reduced and those affected regain consciousness. (fp)
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