Three days ago Bobbi Kristina Brown, daughter of American legend Whitney Houston and musician Bobby Brown, was found unresponsive and facedown in a bathtub. Eerily, Whitney Houston was found unresponsive in a very similar manner, unconscious in a Beverly Hills bathtub in 2012. Her eventual death was deemed secondary to “the effects of atherosclerotic heart disease and cocaine use.” Not much has been revealed about Bobbi’ Kristina’s circumstances, and the privacy of the family has, for the most part, been well respected.
It is best not to speculate about a potential cocaine addiction, growing depression, or an alcohol dependence—we, quite frankly, have no idea what circumstances led to her being found in a tub full of water. Yes, the eerie resemblance to her mother’s passing is intriguing, but we can’t come to conclusions until her doctors and family release the cause.
So while it remains unclear as to what led to Bobbi’s unconsciousness, it is fairly likely that she suffered oxygen deprivation to her brain. The brain is especially sensitive to oxygen deprivation; early symptoms include confusion, lethargy, and dizziness. Just two minutes of a lack of oxygen can lead to irreversible brain damage.
Why is oxygen so vital to the body? The answer lies in the cell’s mitochondria, the power factories that depend on oxygen to make adequate molecular energy for the cell. In oxygen’s absence, the cell resorts to inefficient back-up power production, leading to buildup of lactic acid, disruption of most proteins and enzymes, and cell death.
So how are some prolonged near-drowning victims able to survive without brain damage? Colder waters lower the body’s temperature, slowing down metabolic activity everywhere. Certain regions of the brain are put into a “standby mode,” able to tolerate longer periods of oxygen deprivation than at normal body temperatures. It’s like eco-mode in a car—the brain requires less oxygen because it turns its metabolic rate way down.
Why place Bobbi Kristina in a medically induced coma? Depending on the circumstances, injury to the brain can cause uncontrollable seizures, or even severe brain swelling if there is evidence of stroke or oxygen deprivation. When you put a patient into a medically induced coma, doctors can control their alertness level, so they don’t feel pain, stop any uncontrollable seizure activity, don’t fight the breathing machine, and subsequently do not raise the pressure within their head. The goal is to put the body to sleep such that all parts of the body reduce their oxygen demand and prevent high metabolic rates that the body is unable to support.
The doctors will periodically lighten the sedation for only a few minutes to see if Bobbi Kristina is improving; such metrics include if she responds to stimulation, follows simple commands like “squeeze my fingers,” or has certain stereotypic movements of the arms and legs associated with devastating brain injury.
Only time will tell what Bobbi Kristina’s recovery will be. As more information is shared with the public regarding her condition, more will be know about what can be done to prevent such tragedy. We wish her and her family peace during a very treacherous time.