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The Making of Medicine

Improving Care for Coma

When you have a loved one in a coma, it is agony hoping that they wake up and that they emerge as they were. The uncertainty, the unanswered questions, the stress … and all you can do is wait.

But now our J. Javier Provencio, MD, has helped assemble an ambitious plan to improve care for comatose patients — and to advance our understanding of coma and other conditions that reduce consciousness.

The plan, developed by a blue-ribbon committee working on behalf of the Neurocritical Care Society’s Curing Coma Campaign, has three main pillars:

  • Better classify different types of comas, to improve diagnosis and treatment
  • Develop better indicators of patient prognosis, known as biomarkers
  • Advance clinical trials of new therapies to recover consciousness

“We envision that a principled, mechanistic approach to predicting and measuring responses to new therapies in the ICU could allow clinicians to provide targeted treatments that are personalized to each patient, ensuring that each patient is given the best possible chance to recover consciousness in the ICU and beyond,” the committee members wrote in a new paper detailing their recommendations, published in the scientific journal Neurocritical Care.

Dr. Provencio was the lead author of the recommendations. He serves as the director of our Nerancy Neuroscience Intensive Care Unit, and he’s deeply vested in improving coma care.

“We now have the tools to understand comatose patients in a way we haven’t in the past. This opens the door to ask the question, ‘Can we improve consciousness in patients in a coma?’” he told me. “This research endeavor aims to help patients and families dealing with the consequences of brain damage gain clarity about the current chances for improvement and maintain hope that, in the future, there will be treatments to help recover consciousness.”

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