From the Research
Beta coma is primarily caused by excessive beta-blocker medication, either through intentional overdose or accidental overmedication, as supported by the most recent and highest quality study available 1.
Causes of Beta Coma
The condition occurs when these medications block beta-adrenergic receptors in the brain and throughout the body, leading to profound central nervous system depression.
- Common beta-blockers that can cause this condition include propranolol, metoprolol, atenolol, and carvedilol.
- Patients typically present with decreased consciousness, bradycardia (slow heart rate), hypotension (low blood pressure), hypoglycemia, and respiratory depression.
Importance of Recent Evidence
The study by 1 published in 2016, provides the most recent and highest quality evidence on the topic, and it highlights the importance of considering the effects of beta-blocker administration pre- and post-traumatic brain injury.
Treatment and Management
Treatment involves supportive care, including airway management, intravenous fluids, atropine for bradycardia, and specific antidotes like glucagon and high-dose insulin therapy.
- Hemodialysis is generally ineffective for beta-blocker removal.
- The condition is potentially reversible with prompt medical intervention, though the recovery time depends on the specific beta-blocker involved, the amount ingested, and individual patient factors.
Clinical Considerations
Beta coma should be suspected in any comatose patient with bradycardia, especially if there's a history of beta-blocker use or access, as indicated by the study 1.
- The administration of beta blockers post-traumatic brain injury in hospital reduces odds of mortality, as shown in the study 1.
- Further research into which beta blockers confer the best benefits as well as the optimal period of beta-blocker administration post-TBI is recommended, based on the findings of the study 1.