coma from lack of oxygen

[cooper0227]

What are the best ways to stimulate a person who is in a coma due to lack of oxygen to the brain.  He was choking on food, turned blue and the went unconscious.  It could of been 10 minutes before he received oxygen by EMT.  
Still in coma and waiting to see signs of him waking up.  It has been six days since this has happened.  When could we see him start to wake up?



This discussion is related to Re: Brain injury due to lack of oxygen.

[nknmw]

Dear Dr. Sharma,

My daughter is 7 years old, she was previously diagnosed with ataxia, ptosis and muscle atrophy. She is generally a healthy and happy child other than her obvious unstable walk. On the 24th of January 2010 she was rushed to hospital because her heart stopped. It took us 5 minutes to rush her to hospital and have the doctors start heart resuscitation. She has been in a coma since then. The doctors stated that she had mild pneumonia and have treated her for this. The doctors have been unable to diagnose what happened and what led to her heart stopping, however, they now believe that she is conscious but not oriented rather than in a coma. She responds to pain, and her father and I sometimes feel she can hear us and even maybe very slightly see us.

My daughter has been on a mechanical ventilator since the incident and any trials to wean her have been unsuccessful. Can you give us any advise on how we can help her breath on her own? Become more conscious and oriented? Any infomation would be very much appreciated.    

[Dr Sharma]

Hi there. This is a very trick question. Neurological outcome following an episode of hypoxia depends on various factors like duration of cerebral hypoxia, when was cardiopulmonary resuscitation initiated and there is a significant difference in the duration of anoxia between patients with favorable and unfavorable outcome after CPR. The duration of post anoxic coma is another prognostic indicator.  In a study, with intensive therapy about one fifth of the unconscious patients 10 min after successful CPR have normal or near normal health after  year, whereas the others have severe impairment of brain function till death. Seizures may occur in previously non epileptics. SSEPs are important to assess potential neurological recovery. Other important test is elevated blood concentration of neurone specific enolase associated with poor prognosis.
The treating neurologist is the best judge and guide into these matters.
Take care.