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Help! Friend in deep coma for 14 days!

Jun Wang juwang at siebel.com
Wed Nov 3 13:39:45 EST 1999

I am not sure if I am posting this message at the right place.  I am posting
it in every newsgroup that is related to neurology.  Please respond if you
could help.
I am not a medical expert and I am doing my best to describe what happened
to a friend of mine back in China.  He has been in a coma for 14 days since
he had a deviated septum correction surgery on Oct. 19, 1999.  (See details
below)  What should the doctors do to revive his brain?  Thanks in advance
for any help.

Please contact:
liyy at cpii.cnpc.com.cn
hlliu at email.hq.cnpc.com.cn
wangjm at cpii.cnpc.com.cn
or Jun Wang, (707)544-7649, juwang at siebel.com, jwang1970 at hotmail.com

Wang Jin, Male, 29, healthy before operation, no history of smoking or
alcoholism.  He had a deviated septum correction surgery on Oct. 19, 1999,
during which he was under general anesthesia.  His breathing and heartbeat
stopped unexpectedly after the operation, and were restored about 1 to 2
minutes afterwards after the doctors performed an emergency procedure.
However, he has been in a middle to high degree coma since then.  He has
also developed cerebral edema.  It has been 14 days by now.  Currently the
cause for the coma is still unclear.

(1) 10/19/1999    During the emergency procedure that the doctors performed
to restore his breathing and heartbeat, he had a sudden seizure.  (He has no
history of seizure disorders.)
(2) 10/21/1999    He had some small movements (e.g., slight arm lifting, and
heart rate acceleration) in response to his mother's voice.
(3) 10/23/1999    He had some relatively large movements (e.g., lifting
right arm above bed, trying to lift head up) in response to his mother's
voice, but his heart rate accelerated to 120.  His mother stopped calling
him, fearing that continuing to do so might cause further damage.  After
that, he had complications including respiratory alkalosis poisoning, high
blood pressure, fever, etc, and he did not show much response to relatives'
voices any more.
(4) 10/26/1999    He was moved to Intensive Care Unit.  The doctors
diagnosed that he was in middle to high degree coma.  They also found that
he had developed cerebral edema, electrolyte imbalance (high Na+ density),
liver and kidney function weakening.
(5) 10/29/1999 afternoon    Body temperature decreased.  Heart rate, pulse,
and blood pressure were moving within normal ranges.  Alteration in
respiratory pattern and slight pupil shrinking (0.05mm) were observed.  He
was not responding to stimuli.  High electrolyte Na+ density was also
observed.  The doctors suspected that it was due to alteration in calcium.
They decided that the key was to solve the brain and internal organ
poisoning.  They performed blood exchange between 3:00pm and 5:00pm
(6) 10/30/1999 morning    Blood test showed good results.  After the blood
exchange, his liver, lung and kidney functions improved.  Urine 50 ml/hr.
Electrolyte Na+ ion density slightly above normal (156).  After removal of
ice cap, body temperature climbed up slightly to 35.5 C (95.9 F), complexion
looked good, brain had no obvious reaction.  Glucose content dropped from
>200 on 10/29 to 186.  The doctors decided that the key was to revive the
brain.  In the afternoon, he had high fever (38 C, or 100.4 F), his blood
pressure rose to 123/176, and his heart rate slowly accelerated from normal
to 139-141 /min.  The doctors used drugs to slow his heart rate, but his
heart rate accelerated again once they stopped using drugs.  Eventually his
heart rate came back to 90-100 /min in 5:30pm - 7:00pm.
(7) 10/31/1999 morning    Blood pressure slightly above normal.
Bio-chemical indices generally improved.  Electrolyte density decreased to
149 from the previous 154.  Heart rate around 110 /min.  Pupil enlargement
was observed.
10:30am    Heart rate 128/min.  His left arm reacted to stimuli.
2:00pm    Body temperature 39 C (he was wearing a ice belt)
3:00pm    Body temperature 39 C.  Blood pressure 74/125.  Heart rate 110-118
/min.  Slight response to his mother's voice was observed.
7:00pm    Blood test showed normal results.
(8) 11/1 Performed tracheotomy surgery

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