Joan Rivers in Medically Induced Coma-UPDATED

Joan Rivers remains in a medically induced coma since her admission to NYC’s Mount Sinai Hospital last Friday. Rivers was taken there after suffering a cardiac arrest during a medical procedure on her vocal cords in a physician’s office.

Daughter Melissa Rivers rushed to her mother’s side and confirmed that “at this time she does remain on life support.” She released a statement today saying:

“On behalf of my mother and our family, we are extremely grateful for all the love and support we’ve received.  I know my mother would be overwhelmed by the continued outpouring of kindness and I want to thank everyone for keeping us in their prayers.”

What is a medically induced coma?

A medically induced coma is when a patient receives a controlled dose of an anesthetic to cause a temporary coma or a deep state of unconsciousness. The objective is to give enough medication to significantly slow brain wave activity. Drugs used include pentobarbital, thiopental, or the drug of Michael Jackson fame, propofol.

This type of coma is typically used to protect the brain from swelling. The brain swelling may be caused by injury (such as was the case for Gabby Giffords) or after brain surgery. Being in a coma reduces the blood flow through the brain as well as metabolic rate of brain tissue.

When in a medically induced coma, a patient’s vital signs must be constantly monitored by an anesthesiologist or other physician. Patients are usually intubated and ventilated (this means that a tube is placed in the windpipe and a machine breathes for you). This is done only in a critical care setting.

Why would doctors use them after cardiac arrest?

According to Dr.  Bradley Flansbaum, a physician at Lenox Hill Hospital in NYC, a medically induced coma slows the body down to minimize damage to the brain and other vital organs.

“To put it in simple terms, if you think of the body as a big machine that requires oxygen and blood, when you slow the body down, it requires less oxygen and less energy than it would normally require. If there’s an injury and something happens, like the heart stops, the brain doesn’t get enough blood and enough oxygen. So the cells and all the machinery in the brain can become damaged.”

UPDATE Sept 4, 2014

Comedy icon Joan River died today. In a statement from her daughter Melissa:

“It is with great sadness that I announce the death of my mother, Joan Rivers. She passed peacefully at 1:17pm surrounded by family and close friends.”

And in pure Joan Rivers fashion, she told her daughter what she wanted for her funeral:

“When I die (and yes, Melissa, that day will come; and yes, Melissa, everything’s in your name), I want my funeral to be a huge showbiz affair with lights, cameras, action … I want craft services, I want paparazzi and I want publicists making a scene!”

“I want it to be Hollywood all the way,” she continued. “I don’t want some rabbi rambling on; I want Meryl Streep crying, in five different accents. I don’t want a eulogy; I want Bobby Vinton to pick up my head and sing ‘Mr. Lonely.’”

“I want to look gorgeous, better dead than I do alive,” she wrote. “I want to be buried in a Valentino gown and I want Harry Winston to make me a toe tag.”

“And I want a wind machine so that even in the casket my hair is blowing just like Beyoncé’s.”

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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