Euro-confusion over coma patients

Tuesday June 23rd, 2009

Doctors and health professionals across Europe have little agreement on key issues about the treatment of coma patients, a conference heard yesterday.

A survey published yesterday showed "quite different attitudes" between different professionals in their approach to patients in a permanent vegetative state and those deemed to have minimal consciousness.

The findings were released at the conference of the European Neurological Society in Milan, Italy, attended by some 2,900 experts.

Experts say as many as 230,000 people in Europe annually fall into a coma - and 30,000 of these end up in a permanent vegetative state.

Researchers Professor Gustave Moonen and Professor Steven Laureys, of Liege, Belgium, found that 65 per cent of professionals found it acceptable to stop artificial feeding and hydration for patients in a vegetative state. Just 29 per cent agreed to this measure in the case of minimal consciousness.

But 52 per cent felt that minimal consciousness was worse for patients than being in a vegetative state.

Professor Moonen said: "There are quite different attitudes throughout Europe towards patients in a minimally conscious state and a vegetative state.

"In light of the high rates of diagnostic error in these patients, the necessity for adapted standards of care for minimally conscious state as compared to vegetative state is warranted."

In a second study the same researchers reported on brain scans, using MRI, of these patients.

The researchers said these showed the brains of patients in a vegetative state to be in a very different condition to those diagnosed as brain-dead.

Professor Laureys said they had found evidence of "significant" activity in the brains of vegetative patients - whereas this was not found in brain death.

ENS abstract O82: Demertzi et al, Attitudes towards disorders of consciousness. Do Europeans disentangle vegetative from minimally conscious state?

ENS abstract O104: Soddu et al, fMRI “resting state” brain connectivity in vegetative state: clinical application of a novel automated quantification method

Tags: Brain & Neurology | Europe

Printer friendly page