ICU sedation

[Beccamac]

Hello,

Was just looking for some information on other people experiences. My Dad has a major heart attack 13 days ago, he’s been in ICU since. He was hit with a bad chest infection and when he was first in. Which finally seems to be clearing. He has a tracheostomy last Wednesday, as they were struggling to reduce the sedation and were worried about infection. They have now successfully managed to reduce his sedation fully. He is still on a ventilator however is doing all the hard work himself apparently. He has had CT scans however they are worried about his brain function, and his going for a MRI tomorrow. He is reacting to nurses, asking him to stick his tongue out, or wiggle his toes. However he is not focusing on them when his eyes are open. I wondered if anyone had experiences of coming out of sedation.

Thanks

[FamilyHistorian]

Hi first of all this is the best group to find support for both patients and relatives.

In relation to your specific question - everybody is different and we talk about being normal - what every normal is!

I had 2 admissions to our local hospital before Christmas, I caught pneumonia had several heart attacks and my aortic valve previously replaced 8 years before was rapidly breaking up. I was seriously ill and the family were called in for the usual warning. However I was operated on before Christmas then sedated, had a tracky and was on ventilation for 6-8 weeks. I came home mid March. From what I can tell the patient won’t necessary come round from sedation until they are ready. In my case they kept trying to bring me round and then suddenly I was ready. I had tremendous weight loss, had to learn to speak, swallow and eat also I had to learn to walk. I was very weak. Your dad may well have nightmares, hallucinations and be affected in other ways.

On the ICUSteps website you will find some really useful information.

Although I don’t live in Cheshire I have joined the Chester group and provide many services via zoom

Ps I am 72

[Sepsur]

Welcome to this forum @Beccamac,

Whilst it is an elite club that no one would wish to join, I hope you find the reassurance here that you seek. Many of us have had extremely complex paths back to normal life after critical illness, although life may have changed for ever, this does not mean that a good quality of life cannot be achieved.

I suffered numerous occasions where my heart failed, I was miraculously kept alive after many life threatening infections. I came round after 57 days coma, with ICU delirium, so baffled as to what had gone on, so weak, in fact I could only lift my forearms a few inches & my thighs - every other muscle had ‘dissolved’ - on life support - the body can lose 1kg of lean muscle a day. It takes much longer to rebuild this than it does to lose it. They say it takes approx 12 days for everyday you are on life support to recover.

Have a look on this link, there are various pdfs that I hope you will find useful.

icustepschester.org/informa...

Let us know how your father gets on.

[Beccamac]

Thank you so much for your replies. My Dad is 60, had never had any previous heart issues till his cardiac arrest. Today has been more positive and we received news from the consultant that his conscious level is improving. They are less concerned about brain injury, however still hoping to carry out a MRI scan tomorrow. Everyday is a rollercoaster.

[Sepsur in reply to Beccamac]

Indeed it is - MRI scans are really thorough so it’ll set all your minds at rest 🤞🏻

[Woo2]

Hi there Beccamac,

I'm 4 years younger than your Dad.

I had Covid-19, but your Dad's experience so far is spookily similar to mine.

I was delirious and hallucinating so much that they kept repeating brain scans because they were so concerned about brain damage. Personally, I think it was a combination of my weirdly over active imagination and the effects of the sedation drugs on me. All the tests were clear and eventually the drugs did wear off.

Recovering from ICU is a long process, and your Dad is doing fine!

[Sepsur in reply to Woo2]

Hi @Woo2

Apparently there were a few factors at play for you guys. Under normal circumstances around 50% of critical care patients experience some level of delirium, the longer you are sedated the greater the chance, although I know of one man sedated for 10 days who has terrible recurring episodes after a considerable time.

During the height of the pandemic, ICU teams were running out of their preferred paralysing agent ( worldwide shortages) so they were having to resort to older generation sedatives to put people in a coma - these had the effect of a higher frequency of both delirium, cognitive dysfunction & neuropathy, coupled with this, many Covid patients were frequently proned. To get the patient to synchronise with the ventilator during proning it is often necessary to sedate to a deeper level. The math being - more sedation more chance of delirium/ slower to wake - especially with the less friendly sedatives.

Mine, thankfully lifted very quickly.

[Woo2 in reply to Sepsur]

Thanks Sepsur!

Your comments fit perfectly with my experience, I don't know which drugs were used, but I do know I was proned and that I was delirious for a couple of weeks after coming out of ICU.

[stevet11753]

This may seem a strange question but, does your dad wear glasses? I'm short-sighted, so when I was coming out of sedation I had to deal with everything being blurred in addition to the general confusion. Maybe this could explain your dad's difficulty with focussing?

[Beccamac in reply to stevet11753]

Hello,

Thank you for your response. He does wear glasses all the time, we put them down so hopefully they have put them on. They say now he is focusing on people. They have decided not to put him to a MRI scan today as they feel at this point of time they don’t need to. Hopefully the progression will continue.

[Sepsur in reply to Beccamac]

Good news