Iatrogenic delirium and coma: a "near miss"

Chest. 2008 May;133(5):1217-20. doi: 10.1378/chest.08-0471.

Abstract

A 66-year-old woman was cared for at two referral institutions following a witnessed cardiac arrest in a local emergency department. Despite aggressive initial care, she failed to regain consciousness during a 28-day course. Based on an erroneous neurologic diagnosis of anoxic encephalopathy, pessimism regarding likelihood of improvement existed, prompting clinical consideration of withdrawal of care. The correct diagnosis of iatrogenic drug-induced coma alternating with drug-induced delirium only became apparent after the IV administration of repeated doses of a benzodiazepine antagonist. The patient and husband (co-authors) provide insights often unheard within care circles.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Coma / chemically induced*
  • Coma / diagnosis
  • Coronary Artery Bypass
  • Coronary Stenosis / surgery
  • Delirium / chemically induced*
  • Delirium / diagnosis
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Hypnotics and Sedatives / adverse effects*
  • Iatrogenic Disease*
  • Lorazepam / adverse effects*
  • Postoperative Care / adverse effects*
  • Postoperative Care / methods
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Hypnotics and Sedatives
  • Lorazepam