A Life-Saving Sniff

A Life-Saving Sniff

October 2020 – Article 1:   

“I’m sorry, but your loved one is in a vegetative state coma and chances of recovery are uncertain.” What heartbreaking news for anyone to hear.

Researchers at Israel’s Weizmann Institute of Science have now demonstrated that a simple “sniff test” can predict if someone is likely to regain consciousness.

Results of the study, published in the journal Nature, examined whether 43 people who were said to be in a vegetative state reacted to smells by measuring changes in their nasal airflow.

It’s based on the principle that our breathing changes in response to odors. For example, an unpleasant odor will result in shorter and more shallow sniffs.

As many as 60% of people who suffer a severe brain injury can experience a diminished, or complete loss of smell.

According to the findings, all participants who experienced a slight change in airflow regained consciousness.

Following a severe brain injury, it’s often difficult to determine whether the person is conscious or unconscious. Current diagnostic tests—which generally analyze eye movement, head movement, verbal responsiveness, and response to pain—can be incorrect up to 40 percent of the time.

“Misdiagnosis can be critical as it can influence the decision whether to disconnect patients from life support machines,” explained Dr. Anat Arzi, who led the research.

Published evidence from Canada involving a large sample of people in ICU with traumatic brain injuries found that approximately 70 percent of deaths were due to withdrawal of treatment. In about 60 percent of those cases the decision to stop treatment was made within 72 hours.

This latest research suggests that this simple, inexpensive test can help doctors more accurately understand the severity of someone’s brain injury and to what degree they are conscious or unconscious.

In some cases, results of the sniff test were the first sign that they were about to recover consciousness. Moreover, the test not only predicted who would regain consciousness, it also predicted with about 92 percent accuracy who would survive for at least three years.

However, it was noted that while the test can predict consciousness recovery, it does not provide information about how conscious the person will be or their functional outcome.

The test involved using jars containing pads that were soaked with a variety of odors, including pleasant-smelling shampoo, rotten fish, and some jars had no odor. The jars were held to the noses of 43 people who were considered to be in a vegetative state. Each jar was presented to each person ten times in a random order.

Those with brain injures were characterized as either having “unresponsive wakefulness syndrome” (also known as a vegetative state), or in a “minimally conscious state”, characterized by irregular periods of awareness.

For a more detailed explanation of the various stages of comas see the GRTL Newsletter article: “Wanted Dead or Alive Part: Essential Medical Terminology.”

“The fact that the sniff test is simple and potentially inexpensive makes it advantageous,” said Dr. Anat Arzi. “It can be performed at the patient’s bedside without the need to move them—and without complicated machinery.”

If further testing supports this initial study, it will drastically change how coma patients are treated. Please pray that this becomes an accepted procedure in Georgia and around the world.

Sources: medpagetoday.com; timesofisrael.com; sciencedaily.com; nancyvalko.com.

By Wayne DuBois

Georgia Right to Life

Media Relations Advisor