How Do Comatose Individuals Breathe on Their Own?

When a person is in a coma, their brain may be in a state where it does not respond to external stimuli, yet many basic bodily functions can still be maintained. Breathing is primarily controlled by the brainstem, which oversees autonomic functions such as heart rate and respiration.

Brainstem Function

Ensure the brainstem is intact and functioning, breathing can continue without external assistance. This means that a comatose person can still breathe on their own, although they might be unresponsive externally.

Spinal Reflexes

Some reflexes controlling breathing may still be active, allowing for involuntary breaths. These reflexes can continue to function, even if the higher brain regions are not.

Mechanical Ventilation

When the brainstem is damaged, or the person is unable to breathe effectively, mechanical ventilation may be used to assist with respiration until recovery or further medical intervention. Mechanical ventilation involves the use of a ventilator, which can intubate the patient to deliver air and oxygen to the lungs.

Evaluation of Coma Severity

The Glasgow Coma Scale (GCS) assesses the level of consciousness and brain function, providing a score that indicates better neurological function, potentially correlating with the ability to breathe independently. A higher GCS score suggests that the brainstem is functioning well and the person might be able to breathe on their own.

In summary, if the brainstem is functioning, a person in a coma can breathe on their own. If not, medical support will be necessary to ensure adequate respiration.

Some Special Cases

For some, mechanical breathing systems are used as life support. This highlights the vulnerability of the autonomous nerve system, which is located deeper in the brain and is less susceptible to trauma compared to the brainstem. The basic operations of the body are controlled by this nervous system, allowing for regulated breathing and other essential functions.

Personal Insight

A former comatose patient explains that upon entering a coma due to ruptured lungs, they required full life support initially. Remarkably, the human body has the ability to heal itself when given the opportunity. This underscores the resilience and healing capacity of the human body.

The severity of a coma can vary. A person can breathe normally without being conscious, which highlights the autonomy of the lower brain functions. Extreme cases might require prolonged mechanical ventilation, which can last from a few weeks to years in rare instances. Understanding these nuances is crucial for accurate diagnosis and effective treatment of comatose patients.