Artificial coma
The artificial coma is not to be confused with the actual coma. It is a controlled deep sleep state in which the body is supposed to recover. According to experts, the risks of artificial coma are very low.
What is an artificial coma?
The artificial coma is actually wrongly referred to as such. It is not an actual coma, but rather a controlled long-term anesthesia. The patient is specifically put into a drug-induced deep sleep. In this way, he is freed from external stressors and pain. His body can recover better in this state. In the intensive care unit, he is monitored around the clock by doctors.
Most organs continue to work reliably during coma. Breathing is mechanical. Nutrition is usually intravenous. An artificial coma can reach different depths. Weak artificial comas facilitate waking up and therefore deep forms are preferred. The comatose state lasts between days and months, depending on the individual case.
Applications
The artificial coma is suitable for different indications. After serious operations, for example, there is this healing indication, for example after certain heart operations or brain interventions. In these cases, the patient benefits from painlessness in the deep sleep state.
In addition, artificial deep sleep gives the patient’s body time to let the intervention wounds heal. In the sleep state, regenerative processes take place at a much higher speed than in the waking state.
Since the body spends more energy on individual bodily functions such as motor skills and perception when awake, much less energy remains for regeneration than in the sleeping state.
Toxins are also removed better and faster from the body during deep sleep than during wakefulness. The artificial coma takes advantage of all these effects. Another indication for an artificial coma can be serious illnesses and accidents. Especially after severe traumatic brain injuries or strokes, the artificial coma often makes sense in order not to endanger brain functions.
With trauma to the skull, as well as with disease processes such as stroke, the patient’s brain swells. This increases intracranial pressure. In the worst case, nerve tissue and blood vessels of the brain become jammed and die, so that life can be in danger. In an artificial coma, the brain’s oxygen and nutrient requirements decrease, causing the brain to swell. The intracranial pressure decreases again and the danger to life decreases.
Typical applications of artificial coma:
How long does an artificial coma last?
In order to put patients into an artificial coma, a combination of anesthetic drugs and painkillers is usually used. The exact mixture of drugs depends on the patient’s condition in the individual case. The dosage also determines how shallow or deep an artificial coma is. How long patients have to stay in an artificial coma differs from case to case.
The underlying disease or severity of the injuries has a significant influence on the decision about the time span. The body can recover in a few days with milder underlying diseases. However, an artificial coma usually lasts several weeks. Months are possible, but not the rule. The longer the patient is in an artificial coma, the more likely complications such as pneumonia become.
What happens in an artificial coma?
If indicated, an interdisciplinary team of doctors discusses the risks and benefits of an artificial coma for the condition of the individual patient in detail. If the benefits predominate, the patient is intubated so that he can be connected to the ventilator via a hollow probe and artificially ventilated. In addition, the patient is given access to intravenous administration of painkillers and sleeping pills.
In addition, the patient must be protected from thrombosis. Drugs with different effects are used to induce coma: in addition to sedatives, hypnotics, benzodiazepines and propofol, opioid analgesics and psychotropic drugs are used. As a rule, doctors are guided by the Richmond Agitation Sedation Scale. In the intensive care unit, the patient is closely observed for the time of coma. One of the most important parameters in this context is intracranial pressure. If intracranial pressure increases, surgical interventions may have to take place, such as the opening of the skullcap.
All vital functions of the patient are regularly scrutinized. As soon as the patient’s circulation has stabilized and the doctors consider the patient to be stress-resistant again, they initiate the tapering of the coma. Bit by bit, they reduce the supply of sleeping pills and keep a close eye on the vital functions. In the event of complications, the dosage of sleeping pills may have to be readjusted and the tapering must be delayed.
What is the recovery phase like?
The doctors awaken the person concerned from his artificial coma as soon as the indication for the coma has calmed down. The dosage of the anesthetic is slowly reduced so that the patient’s body is not overwhelmed. If anesthetics are tapered off too quickly, withdrawal symptoms, an acute state of Confusion or seizures occur .
The length of the coma, the age of the patient, his constitution and his state of health determine the duration of the tapering off. In most cases, artificial respiration continues because the respiratory muscles recede, especially in the case of prolonged comas. Step by step, the patients are weaned off the ventilator. Patients in longer comas sometimes need weeks to breathe independently again. Symptoms such as confusion, Anxiety , insomnia , pain, and delusions are regular complaints after an induced coma.
The body is under extreme stress after an artificial coma. So that the patient’s blood pressure remains within the normal range and the patient does not endanger himself, for example, by the uncontrolled removal of catheters or drains, Sedative are often given when he wakes up. After the coma, a regulated day-night rhythm should be aimed for through daylight and the use of watches, sleep masks or earplugs. Familiar smells, old photos, music or familiar objects help to overcome delirium.
Who bears the costs?
The artificial coma is covered by health insurance if indicated. However, after the hospital stay, depending on the health insurance company and the type of insurance, a deductible may be required from the patient. As a rule, this deductible is ten euros per day and a maximum of 280 euros in total. Patients with supplementary insurance usually do not have to pay a deductible.
Risks, complications and side effects
The risks and side effects of the artificial coma are low. Difficulties only arise when you wake up, since the control systems often do not run immediately without problems. This risk can be prevented relatively well by tapering off.
Delirium is one of the most common after-effects of artificial deep sleep. If patients do not wake up from the artificial coma, this is usually not due to the coma itself, but to the injuries.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.