From the Journals

1 in 4 Unresponsive Coma Patients May Retain Some Awareness


 

FROM THE NEW ENGLAND JOURNAL OF MEDICINE

Challenging Research

Commenting on the research, Aarti Sarwal, MD, professor of neurology and section chief, Neurocritical Care, Virginia Commonwealth University, Richmond, Virginia, noted that this was a “very challenging” study to perform, given that only a few academic centers are equipped to perform both fMRI and quantitative EEG analysis.

“In general, finding patients this far out, who have access to clinical, radiological, and electrophysiological testing and were provided good care enough to receive these, is a mammoth task in itself.”

Dr. Sarwal said the study builds on efforts of the Curing Coma campaign , a clinical, scientific, and public health effort of the Neurocritical Care Society to tackle the concept of coma as a treatable medical entity.

“It continues to highlight the challenges of prognostication in acute brain injured patients by showing a higher presence of cognitive function than previously perceived,” she said.

Dr. Sarwal believes that the study’s largest impact is underscoring the need for more research into understanding the degree and quality of cognitive processing in patients with a disorder of consciousness. But it also underlines the need for a “healthy debate” on the cost/benefit analysis of pursuing such research, given the limited number of patients with access to resources.

“This debate needs to include the caregivers and families outside the traditional realms of stakeholders overseeing the science.”

Although communication with comatose patients is still “a ways away,” this research is “a step in the right direction,” said Dr. Sarwal.

The study was funded by the James S. McDonnell Foundation and others. Dr. Schiff and Dr. Sarwal report no relevant financial disclosures.

A version of this article first appeared on Medscape.com.

Pages

Recommended Reading

What is the psychological cost of performing CPR?
MDedge Cardiology
Three wild technologies about to change health care
MDedge Cardiology
A doctor intervenes in a fiery car crash
MDedge Cardiology
A doctor must go to extremes to save a choking victim
MDedge Cardiology
Pulmonary embolism workup needed for any sudden onset of exertional dyspnea
MDedge Cardiology
Guide explains nonsurgical management of major hemorrhage
MDedge Cardiology
Upping CO2 does not benefit OHCA patients: TAME
MDedge Cardiology
AHA updates CPR guidelines on cardiac arrest after poisoning
MDedge Cardiology
Which Emergencies Are Genuine Emergencies?
MDedge Cardiology
How Drones Are Reducing Emergency Response Times
MDedge Cardiology