Coma science: intensive care as the new frontier

Excerpt

Beginning in the middle of the last century, increasingly large numbers of comatose patients have survived life-threatening conditions thanks to the widespread use of mechanical ventilation. The chances of reasonable functional outcomes for survivors of acute brain injury rose over the following years, largely due to advances and standardization of critical care management and improvements in neurosurgical techniques. Neurocritical care physicians routinely manage patients with acute brain injury, who are frequently unconscious. This young specialty has spent the past couple of decades making large strides in harmonizing clinical practice, advancing societal representation, and developing a unique, large body of evidence for critical care physicians treating patients with neurological injury. Having established national and international societies that represent practitioners of neurocritical care, generating guidelines and practice statements, and establishing organized training with board certification, the field is now undergoing a scientific transformation. At this junction, an increasing number of research groups are focusing attention on understanding disorders of consciousness in acutely brain-injured patients. Techniques for this coma science endeavor are now available to provide fundamental insights into the biology of consciousness of the acutely injured brain. …