Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED” and in last week’s episode I answered another question from our readers and the question last week was
You can check out the answer to last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer question from one of our readers and the question this week is
My son’s father had a heart attack and is not waking up in Intensive Care after cooling therapy! Please help!
This question from Karen formed part of an email consulting/counselling session with me.
My son’s father had a previous heart attack last year.
He had a second heart attack 3 days ago and we were told he lost oxygen to the brain during the heart attack.
When the ambulance arrived they also had to defibrillate him.
He was in a cooling therapy in Intensive Care for two days and they are now trying to wake him up from the Induced coma and they are now trying to wean him off the ventilator.
We are wondering what the expected time frame is for him to come out of the induced coma, wake up and get off the ventilator?
So far my son’s father shows little signs of waking up and we are worried that he may have some irreversible brain damage.
Also, my son and I are not allowed to get any information from the Intensive Care team about my son’s father’s condition, because we are not the next of kin/POA.
Can you shed some light on this please?
thank you for your question and thank you for signing up for email counselling/ consulting with me.
I can only imagine how stressful this must be for you and your son, not getting enough information about your son’s father’s condition.
Given that your son’s father had two Heart attacks within less than 12 months and given that on his last heart attack three days ago he had to be defibrillated things look pretty difficult from my perspective.
The heart attack must have caused some irregular heart rhythm like VT(Ventricular Tachycardia) or VF(Ventricular Fibrillation) that caused the heart to basically stop working and produce a meaningful blood pressure, therefore the defibrillation.
The heart attack therefore must have caused a cardiac arrest, which is actually much worse than a heart attack.
If the heart needs defibrillation there is always a chance that the heart couldn’t maintain a blood pressure and therefore hypoxia or lack of oxygen to the brain is a possibility. This is because the heart couldn’t supply the brain with enough oxygenated blood during the cardiac arrest.
You mention in your email that this might have been a possibility and you are voicing concern that your son’s father may have experienced a lack of oxygen to the brain.
Quite frankly, if there was insufficient oxygen supply to the brain for more than three minutes, chances are that there may have been irreversible brain damage caused.
As long as your son’s father is in an induced coma, it’s hard to tell whether there is any irreversible brain damage or not.
A CT(Computer tomography) of the brain might answer this question.
Furthermore, the cooling therapy that you are referring to is also a therapy that most Intensive Care Units use nowadays in order to protect the brain and other vital organs after a possible insult through lack of oxygen for a prolonged period to the brain or to other vital organs.
Generally speaking what’s happening is that after cooling therapy and the induced coma, it might take a day or two until your son’s father might wake up.
Normally during the cooling therapy that can last for up to 72 hours the drugs used to keep your son’s father in the induced coma are quite potent and therefore you can expect a delay in “waking up”, even after the sedative drugs have been ceased.
Furthermore, if a hypoxic brain injury has been sustained, you can expect further delays and if your son’s husband hasn’t woken up after two or three days after the medications for the induced coma have been ceased there is a fairly high chance that there may have been a hypoxic brain injury.
Having said all of that, sometimes critically ill Patients in Intensive Care just take their time to “wake up” no matter how quickly the people around them want them to “wake up”.
Further testing like the CT of the brain that I mentioned before should be done if he’s not “waking up”.
If your son’s father has sustained irreversible brain damage it should show up in the CT of the brain and if it doesn’t they should be doing an MRI of the brain to get further clarification.
Even if your son’s father doesn’t have brain damage, once he gets out of the induced coma, he may still not “wake up” as you expected, because he might still be under the influence of the drugs from the induced coma.
He might be confused and agitated, but he might also be perfectly fine.
Be patient. Nothing happens quickly in Intensive Care.
Also, as far as weaning your son’s father off the ventilator is concerned, keep in mind that as soon as your son’s father is coming out of the induced coma, he should start breathing more by himself and he should be able to be weaned off the ventilator. This is irrespective of whether brain damage has been caused or not.
The breathing reflexes and muscles should still work.
As far as your POA/ Next of kin situation goes Karen, most hospitals have the right to withhold information if you are not the POA/Next of kin.
In order to get fully informed you might have to ask your son’s father POA/NOK to give you the information that you want, however they don’t have to do that if they don’t want to.
I hope that helps.
Please let me know if you have any further questions.
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Thank you for tuning into this week’s episode of “YOUR QUESTIONS ANSWERED”and I’ll see you again in another update next week!
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This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!