For doctors, drug-induced comas often a 'leap of faith'
Published 5:30 am, Sunday, March 19, 2006
When a doctor utters the word "coma," the prognosis is usually bleak.
Yet every day, physicians intentionally put patients into comas.
Despite great advances in modern medicine, there are still few options for treating severe brain injuries such as those caused by a blow to the head, a stroke or constant seizures. Physicians can try draining fluid or raising the head of the patient's bed to alleviate potentially fatal swelling.
If those efforts fail, they sometimes decide to push patients to the precipice, as close to brain death as humanly possible.
The procedure, called medically induced coma, slows brain activity almost to a stop by pumping huge doses of barbiturates into the patient. The goal is to give the injured brain a rest in the hope that it will heal itself.
"It's a leap of faith," said Julian Bailes, neurosurgery chairman at West Virginia University School of Medicine. "It's a last-ditch measure when we feel we're at the end of the game. Although it has been very effective for some patients."
Though drug-induced comas have been in use for three decades, the procedure has made headlines in recent months with famous patients such as Israeli Prime Minister Ariel Sharon and the sole survivor of the Sago Mine explosion in West Virginia.
Some medical experts, however, say drug-induced coma is an experimental treatment with little data behind it.
"We're clear about what is therapy and we're clear about what counts as research, but experimentation falls in between the two," said Ronald Carson, an ethicist at the University of Texas Medical Branch at Galveston.
"There are risks involved in doing something, as well as risks involved in doing nothing," Carson said. "We don't know what the person is going to be like at the other end."