What happens in the body when you’re in a coma

The sympathy for the fate of the Russian ice dance Olympic champion Roman Kostomarov is great. After amputations on his arms and legs, the 46-year-old was put into an artificial coma. In the meantime, according to Russian media reports, he is said to have woken up again and breathe on his own.

Why was he put in an induced coma and what happens when you’re in a coma? We clarify the most important questions.

That’s why people fall into comas

Coma is a prolonged state of deep unconsciousness and is the most severe form of impaired consciousness. Those affected cannot be woken up and do not react at all or only very weakly to external stimuli such as light, pain or voices. The term “coma” comes from the Greek and means something like “deep sleep”.

Some neuroscientists now believe that coma is a form of the body’s protective response to life-threatening injuries and extreme pain that a fully conscious person would not be able to endure. The coma often only lasts a few days to several weeks. In the rarest of cases, patients remain in a (waking) coma for several years.

Causes of a coma

There are several causes of a coma. The portal ”
Online doctor
” differs:

diseases of the brain

• stroke
• traumatic brain injury
• Inflammation of the meninges (meningitis)
• inflammation of the brain (encephalitis)
• cerebral hemorrhage
• Epileptical attack
• brain tumor

Metabolic disorder (metabolic coma)

• circulatory failure
• lack of oxygen
• Hypoglycaemia/hypoglycaemia
• renal insufficiency
• hepatic insufficiency

poisoning

• Drugs, such as alcohol and intoxicants
• Married
• Anesthetics

The four stages of coma

Medicine distinguishes between different levels of coma, the transitions between which are fluid:

Light coma, stage I:
The patient is unconscious but shows reactions to pain. The pupils contract in light.

Light coma, stage II:
Pain reactions are only very slight, but the pupillary reflex works.

Severe Coma, Stage III:
Response to pain and pupillary movement are weak, diffuse, and aimless. Muscle cramps may occur.

Severe Coma, Stage IV:
Patient no longer shows any reaction to pain. The eyes are wide open, the pupils dilated, but do not respond to light.

The most important forms of coma

In addition to the classic coma, there are other forms of coma. Patients seem a little more conscious here. According to “Netdoktor”, doctors distinguish between:

Coma, also known as apallic syndrome:
The patient is in the realm between coma and consciousness. The functions of the autonomic nervous system such as breathing, heartbeat and day-night rhythm still work, but patients do not react to external stimuli. They can grasp and even laugh or cry, but these are just reflexes. .

Minimally Conscious State (MCS):
It resembles the vegetative state with open eyes, movements and facial expressions. However, MCS patients show targeted reactions to external stimuli, such as voices from relatives or touch. The likelihood of patients waking up is correspondingly higher. But the transitions are fluid.

Artificial coma:
Strictly speaking, this is not a form of coma, but a long-term anesthetic that doctors can initiate and end in a targeted manner. This puts the brain on the back burner, slowing down its metabolism and reducing oxygen consumption. This makes it easier for patients to be treated, the healing process is accelerated and they feel no pain.

Locked-in syndrome is not to be confused with a coma.
Patients are fully conscious, able to see and understand. However, because they are completely paralyzed, they can only communicate through eye movements. They perceive themselves as prisoners in their own bodies.

This is how coma patients are treated

First and foremost, the causative disease is treated in coma patients. In addition, they usually need intensive medical care and, depending on the severity of the coma, artificial nutrition or ventilation. There are also ergotherapeutic or physiotherapeutic measures.

For people in a vegetative state or with a minimal state of consciousness, coma researchers also call for long-term therapeutic measures. They assume that sensory stimuli for the brain are essential for healing.

Relatives play an important role in this
, because sensory stimuli are also given by being spoken to or touched. Some can even be proven: “Coma patients in particular often react to loving stimulation with a changed heart rate and breathing. Muscle tone and skin resistance also change,” say the experts at Netdoktor.

Measurements in the body difficult

How deep the coma is is often difficult to assess. Although there are methods that map brain activity, such as magnetic resonance imaging (MRT) or PET, the latter makes the metabolic processes in the brain cells visible. However, the brain scans can be falsified by the fact that patients are in a deeper state of unconsciousness during the examination. Experts therefore call for several brain scans to be carried out in coma patients before a diagnosis is made.