Tracheotomy
The normal ventilation for anesthesia is a ventilation tube that is inserted through the mouth into the trachea. It can be used for a short artificial coma, where a wake up after a few days is planned. However, this breathing tube irritates the mucous membranes in the mouth and throat and can lead to pressure sores and open wounds in the oral cavity.
For this reason, a tracheotomy is often resorted to in the case of a prolonged artificial coma. In this case, a small incision is made at the front of the neck and a breathing tube is placed directly into the trachea. This is a possibility to spare the mouth and throat area and to prevent such ulcers, especially in elderly people who have a tendency to pressure sores due to circulatory disorders. Furthermore, the vocal cords are also protected, since the normal breathing tube is also led through the glottis, while the tracheal incision is made below the glottis. Ventilation via a tracheotomy is also tolerated by persons who are awake and can be used after the end of the artificial coma, depending on the underlying disease.
Artificial coma after pneumonia
In case of severe pneumonia with breathing problems, ventilation may be necessary to supply the body with sufficient oxygen. To do this, a breathing tube must be inserted through the glottis into the trachea. Awake persons will not tolerate this breathing tube.
This would lead to nausea and panic reactions. For this reason, the affected person can be put into an artificial coma for the acute phase of the pneumonia. The body is given time to heal and receives sufficient oxygen so that there is no undersupply to the brain and other organs.
However, artificial coma is the maximum stage in the treatment of pneumonia and not the standard therapy. In most cases, drug therapy combined with bed rest and, if necessary, oxygen is sufficient. The maximum therapy may be particularly necessary for vulnerable patient groups, such as small children, the elderly and immunocompromised persons.
