What is a medically induced coma?
“A medically induced coma for the purpose of detox is otherwise known as ‘rapid detox.’ Dr. Castellon said. “This is when a patient is under general anesthesia for several hours while they are given the opiate receptor blocker naltrexone.” Why send the patient into a comatose state?
Can a coma be caused by drug intoxication?
Some cases of coma due to drug intoxication require simultaneous use of various approaches.
Why would you put a patient in a coma?
Patients with brain injuries who are in a coma have a similar pattern. If that pattern is there, then you feel comfortable that the patient is in a drug-induced coma. You are doing it so that you can hopefully protect the brain. What are you protecting the brain from?
What are some of the controversies in the treatment of Comas?
Controversy exists as to the most efficacious agent to use, preference of high monotherapy over combination antiepileptics, therapeutic dose ranges, duration of coma, depth of coma, thresholds for treating abnormal rhythms on EEG, and how continuous should the electroencephalography monitoring be 20).
Is there a drug that puts you in a coma?
The most common drugs used to induce a coma are propofol, pentobarbital, and thiopental. These drugs have a continuous effect on a patient, keeping them in a sustained state of unconsciousness that is necessary for healing to begin.
Why do you get put into an induced coma?
Medically induced coma, performed on critically ill patients, has been used for a quarter of a century or more to put the brain in a state of temporary hibernation to allow time for the brain to recuperate. One of the greatest hazards associated with brain injury is intracranial hypertension.
What does a medically induced coma feel like?
A coma is similar to a dream-like state because the individual is alive but not conscious. A coma occurs when there is little to no brain activity. The patient is unable to respond to touch, sound, and other stimuli. It is also rare for someone in a coma to cough, sneeze, or communicate in any way.
How long does it take to get out of an induced coma?
The length of time a patient is in a medically induced coma is "largely dependent on the disease that you're treating," Souter said. In most cases, a coma is induced for a few days up to two weeks; induced comas longer than a month are extremely rare.
Do you poop if you're in a coma?
When you are in a coma, you will be confined to bed, and all physical needs (such as bathing, turning, and bowel and bladder care) will be taken care of by someone else. General weakness is also very common as you approach death. It is not unusual to need additional assistance walking, bathing, and using the toilet.
Can someone in a medically induced coma hear you?
No. A person in a medically induced coma is unconscious and does not react to external stimuli, such as light, sound, or touch. The brain may process stimuli to some degree, but the person cannot wake up to the stimuli, such as pain.
Do you age slower in a coma?
the cellular mechanism for ageing has been associated with progressive shortening of telomere length on the ends of each chromosome with each cell cycle.. in the contect of this, a coma wouldnt necessarily keep you young, but you would age just the same.
What are the chances of surviving an induced coma?
Studies show a very high overall mortality, ranging between 76% and 89%. 5, 6, 7 Of the surviving patients, only very few recover to a good outcome. The majority of the survivors do so with permanent disorders of consciousness or severe disabilities (see Table 1).
What part of the brain wakes you up from a coma?
We now know that there are collections of nerve cells in the lower part of the brain, called the brainstem, which are responsible for maintaining a waking state.
What is the longest coma ever recorded?
When Edwarda O'Bara died on 21 November 2012, she had survived 15,663 days (about 42 years) in a coma. Born in 1953, in Miami, Florida, O'Bara suffered a childhood history of diabetes, which she successfully managed with insulin.
What is the difference between medically induced coma and sedation?
While a medically induced coma puts a patient in a very deep unconscious state, sedation puts a patient in a semi-conscious state. Sedation is often given to allow a patient to be comfortable during a surgical or medical procedure and is administered through an intravenous catheter (IV), with minimal side effects.
Why do people go into a drug induced coma?
According to the American Society of Anesthesiologists, the most common uses of drug-induced comas involve the presence of serious brain injuries, but other causes include drug overdoses and strokes.
What is a drug induced coma?
What Is a Drug-Induced Coma? When one hears the word coma, it is often accompanied by a negative connotation. This reaction is understandable, as a coma is a natural response by the body to a trauma of some kind. However, a coma can also be used as a medical tool.
What is the most common drug used to induce a coma?
The most common drugs used to induce a coma are propofol, pentobarbital, and thiopental. These drugs have a continuous effect on a patient, keeping them in a sustained state of unconsciousness that is necessary for healing to begin.
What happens when you are in a coma?
A drug-induced coma puts a person into a deep state of unconsciousness, which allows the brain to rest and thus decreases its swelling. The decrease in swelling can result in less pressure being put on the brain, which lessens the risk of damaging effects.
Is a coma a natural reaction?
This reaction is understandable, as a coma is a natural response by the body to a trauma of some kind. However, a coma can also be used as a medical tool. This kind of coma is known as a drug-induced coma or medically induced coma, and it has been found to be effective in the treatment of some patients. Anesthetics are used to induce a coma, as ...
Is a coma a risk?
Risks and Side Effects. There are some risks associated with medically induced comas. According to National Public Radio, the procedure lowers blood pressure, which can lead to complications for some individuals. There can also be issues with a person’s heart that arise during a coma.
Can a drug induced coma cause brain swelling?
Blood flow to the brain can be constricted, and in some cases, brain tissue itself can be harmed. A drug-induced coma puts a person into a deep state of unconsciousness, which allows the brain to rest and thus decreases its swelling.
What happens if you have a brain injury?
What are you protecting the brain from? If you've had a brain injury, what happens is the metabolism of the brain has been significantly altered.
Do drugs accumulate in the brain?
If you do this for an extended period of time, the drugs can accumulate and it may take them a while to wash out of the system as well.
Is anesthesia a reversible coma?
A review paper in the December 30, 2010, issue of The New England Journal of Medicine reveals that such anesthesia is, essentially, a reversible coma. That is exactly what doctors are aiming for in the case of a true medically induced coma, often using the same drugs or extreme hypothermia induced by exposure to a cold environment ...
What is a medically induced coma for alcohol detox?
A medically-induced coma for alcohol detox takes place in a hospital-based, intensive care setting. The procedure requires the presence of an anesthesiologist along with monitoring devices that track the patient’s condition. Sedative drugs are administered at measured doses to keep the patient in the state.
Why do people stay in a coma after drinking?
Trying to stop drinking without needed treatment supports in place only sets you up for failure. If you have a history of chronic or long-term drinking, you’ll likely need the type of protection a medical coma provides.
What are the characteristics of a comatose state?
The two main characteristics of a comatose state are unconsciousness and being unresponsive to outside stimulation. Coma can result from head trauma, stroke or other serious injuries. With a medically-induced coma or medical coma, the patient is placed in a comatose state in a hospital setting.
How does anesthesia work in a coma?
In effect, a medical coma procedure closely resembles the “putting under” process that takes place at the start of surgical procedures. Once under, doctors monitor and control the process to ensure brain functions stay at a certain level. Now is the time to seek help.
What is the purpose of EEG during a coma?
EEG or electroencephalography machines monitor brain wave activity. Drug output may be adjusted to ensure the patient’s brain remains in a state of rest. Drugs commonly used during the procedure include:
Does alcohol depress the nervous system?
Alcohol depresses the body’s central nervous system or CNS. The intensity of withdrawal symptoms you experience reflects the degree of damage done to the CNS. With severe withdrawal, in particular, the body enters into an extremely excited state in its attempt to stabilize CNS functions. Consequently, a medically-induced coma for alcohol detox will ...
Is it bad to be in a coma after alcohol withdrawal?
Detoxing from alcohol addiction can prove painful and sometimes even life-threatening. A medically incuded coma may help shield a person from the most uncomfortable stages of withdrawal and better prepare them for the next steps of recovery .
Why do we need a medically induced coma?
Reasons for medically induced coma. Induced coma is intended to reduce the metabolic demand of the brain cells and is used to protect the brain during major neurosurgery. Medically induced coma is currently used in clinical settings as treatment for patients with high risk of brain injury either from physical trauma, ...
How long is a medical coma?
The medical coma is often required for several days. About 55% of the glucose and oxygen utilization by the brain is meant for its electrical activity and the rest for all other activities like metabolism. This is recognized by something such as an electroencephalogram (EEG), which measures electrical activity in the brain. ...
How does barbiturate help with traumatic brain injury?
Following a traumatic brain injury, an anesthetic drug such as a barbiturate or propofol, is administered continuously to provide brain protection by decreasing the cerebral metabolism and blood flow, and thereby, intracranial hypertension 2) . In the treatment of status epilepticus the anesthetic is administered to directly inhibit activity in the seizure foci 3). For treating both refractory intracranial hypertension and status epilepticus, the state of medical coma is achieved by continually monitoring the patient’s brain activity with the electroencephalogram (EEG) and titrating the anesthetic drug infusion rate to maintain a specified level of burst suppression. Burst suppression is an EEG pattern characterized by intervals of electrical bursts that alternate with isoelectric or quiescent intervals termed suppressions 4) and is an EEG marker of profound brain inactivation. In most cases, once burst suppression is achieved, it can be controlled by decreasing or increasing the infusion rate of the anesthetic to decrease or increase the suppression level.
How long does a burst suppression stay in a coma?
In most cases, the medical coma is required for at least 24 hours and frequently longer . Delivering medically induced coma therapy for refractory status epilepticus patients is challenging because it requires frequent patient monitoring, subjective interpretation of the EEG, and manual titration of IV anesthetic drugs by busy intensive care staff for prolonged periods often lasting 24–48 hours 6). Moreover, subspecialists who are trained to interpret EEG and administer anesthetic drugs are often unavailable, leaving the tasks to non-experts. As a result, many have questioned the quality of induced-coma provided to refractory status epilepticus patients and have searched for ways to improve the therapy 7).
What is a drug-induced state of profound brain inactivation and unconsciousness used to treat?
Induced coma also known as a medically-induced coma or medical coma, is a drug-induced state of profound brain inactivation and unconsciousness used to treat refractory intracranial hypertension and to manage treatment-resistant epilepsy (refractory status epilepticus) 1). The state of coma is achieved by continually monitoring ...
How does barbiturate affect blood flow?
Barbiturates reduce the metabolic rate of brain tissue, as well as the cerebral blood flow. With these reductions, the blood vessels in the brain narrow, decreasing the amount of volume occupied by the brain, and hence the intra-cranial pressure. The hope is that, with the swelling relieved, the pressure decreases and some or all brain damage may be averted. Several studies have supported this theory by showing reduced mortality when treating refractory intracranial hypertension with a barbiturate coma 17).
What is the effect of barbiturates on the immune system?
Barbiturates cause immunosuppression by reduction of phagocytic activity of leukocytes, decreasing activation of peripheral lymphocytes, and depression of chemotactic migration of white blood cells 27). Immunosuppression increases the risk of IV line-associated infections and ventilator-associated pneumonia.
How does recovery from addiction work?
Recovery from addiction requires more than just detox. There are a lot of behavioral components to treating addictions. The addicted person has permanently altered his/her brain. The reward system was likely already compromised (yes, addiction is heriditary) and then further corrupted by the drugs. Addiction is a brain disorder, and so requires a holistic approach to treatment. This requires some behavior and cognitive restructuring.
What happens if you use substances in an addictive fashion?
In reality, continued use of substances in an addictive fashion will result in incarceration or other legal problems. Take the legal question out of it and the person still has to deal with loss of a job, disintegrating relationships, loss of dignity, etc.
Is detox good for addiction?
I’ve been in addiction treatment (provider, not customer) for 5 years and there are general things that apply across the board but each treatment is very individual. Detox does indeed have some therapeutic benefit as Qadgopsaid. My personal working theory for addiction treatment is that the customer needs both the stick and the carrot. They need to feel the pain of addiction and be tempted by the benefits of recovery.
Does withdrawal from opiates have a therapeutic benefit?
Experiencing the psychological and physical withdrawal from opiates does have a distinct therapeutic benefit for opiate addicts. In my opinion. And I’ve detoxed several dozen opiate addicts in my career, via a variety of methods (but not the Waismann method). I’ve also gone thru opiate withdrawal myself via a variety of methods (again, not the Waismann method.)
Why is drug induced coma differentiated from coma?
Differential diagnosis. Drug-induced coma should be differentiated from coma due to structural lesions of the brain and metabolic encephalopathies. There are no hard and fast rules because drug-induced coma may resemble metabolic encephalopathy on one hand and may induce structural lesions in the brain.
What is a coma due to drug intoxication?
This article describes coma due to drug intoxication, including recreational and illicit drugs as well as more commonly used medications such as antidepressant, antiepileptic, and psychotropic medications. Common clinical manifestations are discussed, as well as involvement of organs other than the brain, ...
Why should parents be educated about prescription drugs?
Parents need to be educated to the risks of prescription medications if accidentally ingested by a child, and childproof caps should be utilized. Education in schools, by public awareness campaigns, and by parents is instrumental in decreasing illicit drug use in teenagers and young adults. Patients should be educated to the potential side effects of prescription medications, and doctors, nurses, and other caregivers must also be aware of the potential for iatrogenic encephalopathy and coma when prescribing and administering drugs.
What are some examples of hepatic coma?
Examples of this are hepatic and renal failure and drug-induced hypoglycemia. A case has been reported of hepatic coma due to hepatotoxicity of abiraterone acetate, a drug used for the treatment of castration-resistant prostate cancer ( 17 ).
What is the term for a disorder of the brain that is characterized by a coma?
The term “encephalopathy” refers to generalized dysfunction of the brain with manifestations varying according to the involvement of brain structures, and coma may occur in severe cases. The causes are varied and may be toxic, metabolic, degenerative, inflammatory, vascular, or posttraumatic. The term “drug-induced encephalopathy” is used when ...
What are the stages of a comatose state?
Multiple stages of impairment of consciousness prior to reaching a comatose state include the following (in order of increasing severity): (1) delirium, a state of waxing and waning consciousness with prominent disorientation, fear, and hallucinations, as well as an altered sleep/wake cycle; (2) obtundation, which implies a mild-to-moderate reduction in alert ness, with increasing time spent in the sleep state ; (3) stupor, a state of deep sleep, from which the patient can be aroused only with repeated and vigorous stimulation; and (4) coma. The term coma, as defined in the classic work of Plum and Posner, is reserved for patients who are in a state of “unarousable psychologic unresponsiveness” ( 13 ). Comatose patients do not show any signs of awareness of themselves or of their environment; brainstem reflexes and posturing movements of the extremities are permissible, but eye opening should not occur in response to an external stimulus, and the patient should not move in a purposeful fashion.
How does cyanide poisoning occur?
Cyanide poisoning. This can occur by inhalation or ingestion. Cyanide inhibits electron transfer in the mitochondrial cytochrome oxidase pathway by binding to iron, leading to anaerobic metabolism, lactic acidosis, and histotoxic hypoxia. Clinical manifestations are rapidly progressive delirium, seizures, and coma.