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What is a medically induced coma after a heart attack?
How long after a cardiac arrest can a patient awaken from a coma?
How long can you stay in a medically induced coma after a heart attack?
Nov 26, 2009 · Approximately 80% of patients who are successfully resuscitated from cardiac arrest do not regain consciousness immediately after return of spontaneous circulation, and may remain in a coma for hours or weeks, or even be in a persistent vegetative state.
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Clinical characteristics of poor outcomes for patients who...
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- Overview
- What is a medically induced coma?
- Why would someone need to be in a medically induced coma following a heart attack?
- How long does someone need to remain in a medically induced coma following a heart attack?
- What are the potential risks of being in a medically induced coma following a heart attack?
- What’s the outlook for someone who’s been in a medically induced coma following a heart attack?
- Takeaway
A medically induced coma is usually a last resort option to prevent further brain damage after a serious heart attack or cardiac arrest.
A medically induced coma is a controlled, reversible slowdown of brain function to protect the brain after a severe injury or event, such as a heart attack leading to cardiac arrest. It’s used to allow the brain to heal after it has been deprived of healthy circulation.
A doctor may also use a medically induced coma if brain damage has occurred from a car accident, drug overdose, gunshot, or other serious injury.
Heart attack recovery usually does not require as serious a step as a medically induced coma. But in some cases, particularly if cardiac arrest follows a heart attack, it may be necessary.
A medically induced coma can help the brain and the rest of the body recover more easily. It can also improve the odds of a better outcome.
This article takes a closer look at medically induced comas, including when they’re used, their benefits, and outcomes.
To induce a temporary coma, a doctor administers anesthetic drugs and puts you in a controlled, closely monitored state of unconsciousness. Your brain and metabolism still function but at a reduced level.
While in an induced coma, you are on a ventilator to maintain healthy respiration. Your medical team monitors brain wave activity with an electroencephalogram (EEG).
Targeted temperature management is also a cornerstone of post-cardiac arrest care for people who remain unresponsive after heart function has been restored.
Studies have found that keeping a person in a mild state of hyperthermia — between 89.6°F (32°C) and 96.8°F (36°C) — for 24 hours reduces swelling and damage to the brain and improves neurological outcomes.
A heart attack can reduce blood flow to the brain, potentially causing brain damage.
If the heart attack is mild or treated quickly, there are fewer risks to brain health and a medically induced coma wouldn’t be necessary.
However, a brain that has been deprived of healthy circulation for an extended time or has experienced some other type of trauma is going to work extra hard to maintain function and recover from the damage. There may be swelling and sudden, severe inflammation in the brain.
A medically induced coma can take some of that extra burden off the brain while it recovers, allowing the swelling and inflammation to ease.
There is no optimal time to remain in a medically induced coma. Ideally, you would be in that state for as short an amount of time as necessary to protect the brain and resume the body’s normal functions.
Unlike serious head trauma or similar injury, doctors can often effectively treat a heart attack and restore blood flow in a matter of hours.
Like any major procedure, a medically induced coma has some potential risks and complications. Most side effects, such as disorientation and sleeping difficulties, are temporary.
Some of the more serious and long-term risks can include:
•delirium (memory problems and hallucinations)
•seizures
Because a medically induced coma after a heart attack is reversible, the outlook for a person being induced is usually better than it would be for someone who slipped into a coma from cardiac arrest outside of a hospital setting.
Generally, the shorter the time a person is in a therapeutic coma, the better the chances for a positive outcome.
A medically induced coma after a heart attack is an extreme measure, but it may be necessary if the brain is at risk of severe and permanent damage.
Some lingering cognitive challenges may be present after coming out of the coma, but working closely with your healthcare team may improve your recovery.
- James Roland
The criteria predict a patient’s long-term neurological outcome within the first few days after cardiac arrest [7]. Levy and his team analyzed 210 comatose patients after hypoxic-ischemic events, performing neurologic exams within the first day and then at intervals up to 14 days after coma onset.
- Megan Alcauskas
- 2009
Jun 5, 2018 · Current guidelines recommend performing prognostication no earlier than 72 h after return of spontaneous circulation in all comatose patients with an absent or extensor motor response to pain, after having excluded confounders such as residual sedation that may interfere with clinical examination.
- Claudio Sandroni, Sonia D’Arrigo, Jerry P. Nolan, Jerry P. Nolan
- 2018
Nov 10, 2023 · Survival after a cardiac arrest is dependent on many factors including age and health. The majority of cardiac arrest survivors have some degree of brain injury and impaired consciousness. Some remain in a persistent vegetative state.
Jul 7, 2023 · A medically induced coma is a reversible state of deep unresponsiveness that is brought about by sedative administration in an attempt to protect the brain from traumatic damage. The sedatives trigger unconsciousness by suppressing various aspects of brain activity.
Jul 11, 2019 · Currently, many physicians wait 48 hours after a cardiac arrest for a patient to awaken from a coma, and some even opt to wait 72 hours. But due to testing limitations and other confounding factors, such as therapeutic hypothermia, predicting an outcome may be biased and premature.
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related to: medically induced coma after cardiac arrestCardiovascular outcomes in primary prevention and secondary prevention patients. Visit the HCP website to find clinical data.
