Can audio from friends help coma patients? – 07/10/2023 – Balance and Health

During the period in which he was hospitalized in an induced coma at the Hospital das Clínicas in São Paulo, after suffering burns in the fire in his apartment that led to his death, playwright Zé Celso received audio messages recorded by friends and relatives.

Having contact with the voice of people with an affective bond, even when unconscious, can be good for the patient, experts point out. “It can bring several benefits: well-being, relaxation and even pain relief”, says Leandro Gama, a neurologist at the Hospital Alemão Oswaldo Cruz.

He claims that there are two types of coma. One of them is the one that occurs due to an injury to the brain. A stroke or trauma, for example, can lead to a state of unconsciousness. Another type is that induced by sedation. It is common for this to occur when someone is in a serious state of health, and sedatives cause an effect similar to anesthesia.

In both cases, reproduction of sound stimuli can be beneficial. Gama explains that the reason for this is the release of neurotransmitters associated with well-being, such as dopamine and serotonin. When listening to sounds such as messages from family members or music enjoyed by the person in a coma, activation of regions that release these substances may occur, causing positive effects for the patient.

The topic has been researched for years. A 2005 bibliographic review signed by Brazilian women analyzed ten articles published between 1971 and 1995 on the auditory perception of people in a coma. Much of the research took place in the United States and investigated whether patients would have any response to playing music.

To measure this reaction, one of the most used methods was the electroencephalogram. This exam consists of analyzing brain activity through electrodes placed on the patient’s head.

The review even points out that the ten studies observed a response to music played for those in a coma. However, the analyzed articles had few participants, and the analysis methods did not determine with certainty whether or not there was any stimulus through the sounds.

Another review, published in 2016, assessed the impact that sensory stimulation of different types had on brain-injured patients in coma or in a vegetative state. In terms of hearing, the evidence found was categorized as moderate – that is, there was some evidence that they caused benefits to the patients studied, but they were not so strong.

In another study done in 2015, 40 patients with brain injuries were divided into two groups. In one of them, audios of family members lasting between 5 and 15 minutes were played twice a day. In the other, there was no intervention.

The reproduction of the sounds was repeated for ten days. The authors noticed that, from the fourth day onwards, the group that heard the voices of family members appeared to have a greater degree of awareness. But the small sample weakens the study’s conclusion.

For Gama, this theme still needs to be better explored. Even so, he claims that the benefit can occur and, therefore, the measure can be adopted.

Anxiety

In addition to the benefits in improving the patient’s clinical condition, bringing the person undergoing treatment closer to the family can control everyone’s anxiety. It was for this reason that the PUC-Campinas Hospital team opted to make video calls between relatives and patients with Covid-19 during the most critical moments of the pandemic.

Gleice Guarnieri, executive nurse at the hospital’s adult ICU, explains that patients and family members were very distressed because visits were restricted. Thus, they decided to adopt video calls, monitored by the psychology sector of the institution, in an attempt to promote contact between them.

“They didn’t see their family members. So, we worked on humanizing this issue”, summarizes the nurse.

Similarly, Gama reiterates that approximations through sound tools can generate calming effects in the face of hospitalization for both family members and hospitalized patients – even if they are in a coma. “I think that in any case it can have benefit.”