Medically Induced Coma: Things you should know

The word coma is often accompanied by a negative implication. This reaction is quite understandable, as a coma is a natural response by the body to a trauma of some severe kind. However, a coma can also be used as a medical tool- commonly referred to as a drug-induced coma or medically induced coma. It has been found to be effective in treating some patients, particularly those with severe brain injury.    

A medically induced coma uses medication to attain a deep state of brain inactivity. It is a reversible unconsciousness that doctors purposely induce to protect the brain from damage.

Why is a medically induced coma performed?

A person may continue to experience the effects of a serious trauma for hours, days or weeks after an accident.

A person’s brain may swell in case of serious traumatic brain injury which reduces blood flow and oxygen supply, and can damage brain tissue.

Inducing a coma may give doctors an opportunity to alleviate the swelling and allows the brain to rest by decreasing the brain’s activity. It may also prevent the body from making false move in the process of healing itself.

Reasons for medically induced coma include:

• Traumatic brain injury with swelling and increase in intracranial pressure
• Stroke
• Status Epilepticus - A type of seizure that lasts longer than 5 minutes, or two or more seizures within a 5-minute period, without returning to a normal level of consciousness between episodes.
• Drug overdose

Does a medically induced coma mean death?

No. A person in a medically induced coma is unconscious and does not react to external stimuli, such as light, sound, or touch. However, the brain may process stimuli to certain level, but the person cannot wake up to it.

How a coma is induced?

Doctors have different methods for inducing a coma. For example, they may use anesthesia to limit a patient’s metabolic rate. Alternatively, they may cool the patient’s body, basically relying on hypothermia (medically-induced cooling of the body's temperature sometimes used for patients who have a cardiac arrest) to encourage a comatose state.

What Happens After a Medically Induced Coma?

To end the coma, doctors begin reducing the medication that placed the patient in the coma in the first place. This allows the patient to wake up gradually. The goal remains to eventually withdraw the medication completely and change the ventilator to a mode that allows the patient to develop breathing on their own.

The treatment for reducing brain swelling includes drugs like diuretics or steroids, draining excess fluids from inside the skull or increasing blood flow from the brain. However, when these options fail to generate a sufficient fall in brain pressure, a coma may be induced.

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