Covid-19 patient very slow to wake from sedation

[mrmountain]

I learned a lot from reading other posts here with detailed info on Covid19 cases I couldn’t find elsewhere. So I just wanted to add my Dad’s situation in case anyone has suggestions.

Basically, he went into ICU with Covid four weeks ago and has spent the past three weeks on a ventilator. At first his response to ventilator was good so they took him off sedation more then two weeks ago. But he’s been waking up very slowly since then. Eyes are open, reflex motion with hands, but still not focusing or responding to commands.

We’re trying to be patient but really worried that so much time on the ventilator will be dangerous for him.

Does anyone have any suggestions? The doctors were considering a trach but have postponed it for now.

Thanks again for all the great info on this site and my prayers for all the other sufferers on here.

[Malletus]

Hi mrmountain, so sorry that you are going through this horrible waiting period with your Dad. My husband took over 2 weeks to start to waking after they stopped sedation. He was still on ventilator. Many stories here of covid patients say the same. The doctors were very concerned my husband but eventually he started to open his eyes although for the first week he didn’t seem responsive. He had a head CT to make sure there was no brain damage, thankfully there wasn’t. It was very scary for all the family waiting for him to start responding to staff. His tracheostomy was delayed several times too. But slowly the drugs started to clear from his body and he could squeeze a hand and blink in answer to questions, but orogress was incredibly slow. After 9 weeks in ICU he was stepped down to a ward, and after 11 weeks in hospital I would say his brain is working well, although his short term memory is still patchy.

Hope this helps and your dad is fully awake soon.

[mrmountain in reply to Malletus]

Thanks Malletus, we are in the same situation where he had a CT scan and MRI but they didn't turn up any abnormality. So we think his brain and vital organs are all ok, just need him to wake up fully.

How soon did your husband have the tracheostomy if you don't mind me asking? The doctors have mentioned that but haven't done it yet.

[Malletus in reply to mrmountain]

They did my husband’s tracheostomy after 3 weeks in hospital. They waited until he was stable enough to undergo the procedure. When he became unstable a couple of times it got delayed. Tracheostomy is seen as a positive step and much more comfortable for patients when they do eventually wake up. I’ve just checked my notes, it was 3 weeks after stopping sedation that my husband started responding by nodding and making brief eye contact. The nursing staff were amazing. They would hold the phone or iPad to his ear so we could speak to him and when he started to come round they arranged video calls, I don’t know whether he could see us as his eyes looked unseeing, but yesterday he told me he remembers hearing my voice.

[mrmountain in reply to Malletus]

Thank you, that is kind of encouraging actually. Yes, we have been calling too and the nurses have held the phone up to his ear, so we hope that hearing familiar voices every day will help him to come round. But it has been a long wait already!

[Sepsur]

So many of the family members who visit this site write about this same issue, I know this is cold comfort because of the hell that you are going through but being ventilated post Covid for approx 20-22 days is quite quick in comparison yo some. I cannot imagine how awful this has been for all the families. I do know the long term impact that critical illness had in my family. I was intubated for 57 days and remained in ICU for another 33 days, this was twice as long as the unfortunate Russian couple who got poisoned with Novochok.

My family were ripped apart by the experience & they could sit by my bedside.

What one can also take comfort from is that your Dad will be in the best possible hands & getting the best treatment.

During the height of the pandemic, medics were struggling to get hold of certain preferred sedatives & paralysing agents used to put people into an induced coma. They were having to use drugs that had a greater impact on recovery time, patients were slower to wake, more delirium, greater proportion of neuropathy & myopathy in comparison - I don’t know if this situation has been redressed.

Many Covid patients are also proned, the staff need to sedate more deeply to make sure the patient synchronises with the ventilator, this in turn leads to a longer recovery time, more muscle loss etc etc etc so the patient is weaker at the point that they are trying to wean & wake up. The patients weakness means it’s more difficult for them to support their own breathing and all.

The average time a person stayed on ICU ( prior to the pandemic) was 3.5 days. This puts into perspective the ordeal we have all been through or are going through.

I hope you Dad continues to improve and can move comfortably through the phases to discharge.

[FamilyHistorian]

Hi,

All I can say is hang in there. I went into hospital before Christmas and I have been home now for just over 3 months. I didn’t have the virus and was lucky enough to be able to have visitors. I was on ventilators for 6 - 8 weeks, I still haven’t read the notes the family made. I was also on a tracky! Apparently I wouldn’t come round and then just did. For me that’s when recovery started, from what I can tell, because things aren’t that clear, I wasn’t a particularly nice person so you need to be prepared that might happen. I had to learn to speak, swallow and walk. My weight loss was considerable.

I am on the next stages of recovery which are both physical and mental. For me there was little support in the community but my GP recommended ICUSTEPS. I have joined a sub group and after just 3 weeks I have found their support invaluable, it is for both patients and their relatives. We use zoom a lot and have organised various exercise sessions and group meetings. I must say I have belonged to a number of organisations over the years and without exception the welcome I have had has been amazing especially when you consider how intimate our issues are.

[mrmountain]

Just heard from the nurse that my Dad is responding to commands and making purposeful movements! Finally! I hope that means he's almost ready to come off the ventilator. Fingers crossed. . .