When someone you care about is in a medically induced coma, it can be scary, confusing and overwhelming. You probably have a lot of questions about what's happening and what to expect.
A medically induced coma slows down the activity in the brain and gives it a chance to rest. It is part of the brain injury treatment process for some coma patients.
“It is a deeper state of coma that can help decrease brain activity and reduce brain injury. Shutting the brain off may help stop the injury or reduce the damage,” said Khalid Alsherbini, MD, a neurologist with Banner Brain & Spine.
Here are 10 things you might not know about medically induced comas. They can help you understand this treatment and what it means for your loved one’s recovery.
1. A medically induced coma is used for protection
Unlike a coma that happens because of an accident or sickness, a medically induced coma is something health care providers do on purpose. It's used to protect the brain in serious situations, like after a major stroke, surgery or head injury. It may give the brain the time it needs to recover.
2. It puts the brain into a controlled pause
Health care providers use anesthetics or sedative medications like propofol, midazolam, ketamine or pentobarbital to induce this type of coma and make the brain less active. This may help reduce swelling, pressure or seizures.
3. It's not permanent and it can be reversed
Health care providers like neurologists watch medically induced coma patients closely to see how they are doing. They can change the medications to adjust how deep the coma is or how long it lasts.
“Coming out of it usually involves slowly reducing the medication while closely monitoring the pressure inside the skull, oxygen, temperature and electrical activity in the brain. We want to make sure the person comes out of the coma without restarting the brain injury or seizures,” Dr. Alsherbini said.
4. Some people might still make movements
Even though the person is in an unconscious state, their body might still move a little. You might spot reflexes like twitching or a response to pain. These movements don't mean the person is awake.
5. It's different from regular sedation
Sedation, or general anesthesia, is often used before surgery or procedures to keep people calm or free from pain. “A medically induced coma is a deeper state of coma. It's not for comfort. It's used to decrease brain activity when a brain injury is severe and cannot be controlled using a lighter form of sedation," Dr. Alsherbini said.
6. It can help prevent further brain damage
A medically induced coma helps stop the brain from working hard when it needs to rest and heal to minimize long-term damage. For conditions like traumatic brain injury, ongoing seizures or swelling, slowing down brain activity can stop more damage from happening.
“It reduces the metabolic rate of the brain, stops the cascade of the brain injury and makes sure there’s enough blood reaching the brain," Dr. Alsherbini said.
7. Waking up doesn't happen right away
Even after the health care providers stop giving the medicine, it can take some time for the person to wake up. It might be a few hours or even a couple of days before they are no longer in the coma, depending on their health and the type of medication.
"Sometimes it takes days for the body to clear the medication or the anesthetic used, especially if high doses were given," Dr. Alsherbini said.
8. Recovery looks different for everyone
Recovery could take months and your loved one may need help with things like walking, talking or remembering. “The coma recovery depends on the degree of the brain injury and whether the person responded to treatment," Dr. Alsherbini said. Be sure to ask your loved one’s health care team about what to expect.
Some people are already in a coma state before starting the medically induced coma. “We might use a medically induced coma to stop the brain injury or to control brain pressure, but they might remain comatose after stopping the coma-inducing medication," Dr. Alsherbini said.
You may have high hopes that your loved one will immediately wake up, but medically induced comas are usually used for people who have a severe brain injury or were already in a coma, so recovery may take a long time.
9. It's only used in serious cases
Medically induced comas aren’t used routinely. Health care providers mostly use them in life-threatening situations when the brain injury is severe and cannot be controlled using a lighter form of sedation.
Health care providers might recommend this treatment for:
- Traumatic brain injury
- Major strokes
- Recovery after brain surgery
- Severe ongoing seizures (status epilepticus)
- Swelling or bleeding in the brain
- Serious breathing problems
“Not everyone with brain injury is a candidate for this intervention. Some people might be too sick, have poor heart function or have a brain injury that is so severe that the benefit they might get does not justify the risk of the medically induced coma," Dr. Alsherbini said.
10. Family support matters
Even if your loved one is in an unconscious state, being there can still be important. Hearing your voice or feeling your touch might provide some comfort. You may want to talk to your loved one or play music for them.
The bottom line on medically induced comas
Medically induced comas can give the brain a chance to rest and heal without having to work so hard. They aren’t a routine type of care, but they may be used to help treat certain life-threatening injuries or illnesses.
If you have a loved one who needs a medically induced coma, talking or reading to them or playing music may help, even if it doesn’t seem like it makes a difference.
If you have questions about medically induced comas, reach out to your health care provider or an expert at Banner Health.
