Duration of the artificial coma | Artificial coma

Duration of the artificial coma

The duration of an artificial coma is very variable and depends on many factors. Those affected are kept in an artificial coma until their physical condition is stable and the cause or underlying disease can be controlled without anesthesia. In most cases, the acute life-threatening situation can be controlled after a few days and the anesthesia can be lifted.

In some cases, however, a longer anaesthesia is possible. After about four weeks at the latest, an attempt is made to end the artificial coma. Once the intracranial pressure has stabilized, there are hardly any reasons to maintain the artificial coma in head injuries.

Theoretically, an artificial coma can be maintained for a very long period of time, but in most cases the anesthesia is only maintained for one or two days. The longer the artificial coma, the higher the risk of consequential damage. The wake-up phase is a very critical time and must be closely monitored.

The duration of this wake-up phase depends on the anesthetics used, the underlying disease and the duration of the artificial coma. The drugs are only slowly reduced and not suddenly discontinued, and even after discontinuation, the active ingredients are still present in the body of the affected person for a while.Even ventilation is only slowly reduced, since the body, especially after a long anaesthetic period, must first learn to control all bodily functions again. These include breathing, blood pressure, heart rate and the salt and water balance.

The wake-up process therefore means great stress for the still weakened body. Since a tracheotomy is often performed in cases of a particularly long artificial coma, this prolongs the weaning from the ventilators and thus the recovery phase. From a medical point of view, the wake-up phase ends with the removal of the breathing tube.

However, the perceived period of time is longer for the affected relatives, as the patients initially suffer from memory problems and are still confused. The relatives tend to perceive the end of the wake-up phase as the time when communication with the relative is possible. The artificial coma is a normal general anesthesia, which is maintained for a longer period of time.

Theoretically, there is no time limit for this type of anesthesia. However, the consequential damages and complications increase significantly with a longer maintenance of the anaesthesia. In addition, those affected develop a habituation to the drugs, so that an increase in dosage is often necessary.

This is only possible up to a certain degree. Normally, an artificial coma is not maintained for longer than four weeks. In most cases, the artificial coma is terminated after a few days.

The attending physicians try to keep the duration of the artificial coma as short as possible and still give the body the time that the underlying disease can stabilize well. After four weeks at the latest, an attempt is made to wake up, but this is stopped when the pressure in the brain rises again. In this case, anaesthetic medication is given again and the attempt to wake up is repeated later.

The state of confusion, also known as transitional syndrome, after an artificial coma can vary greatly. Some affected persons are already fully oriented again after a few hours or days, while others suffer from memory disorders for several weeks. In rare cases a permanent disorder develops. The state of confusion is influenced by age, the general condition of the person affected and the duration of the anaesthesia. Alzheimer’s patients are particularly affected.