What is ICU Delirium?

[ComaResearcher]

Do you accept that the meds and lack of oxygen are a sufficient explanation for ICU Delirium or do you believe there may be other answers, possibility spiritual? For example, many Near Death Experiences (NDEs) resemble the coma experience but are occasioned by other events.

[Sepsur]

Sleep deprivation, interrupting circadian rhythms, effects of critical illness - lack of facial features to orientate - because nurses are in PPE - lack of family contact to help orientate, heightening anxiety which feeds into paranoia that is already there. I would suggest that the spiritual element is an extension of a patients own belief system. I was in a 2 month coma - I saw many things - God certainly wasn’t there - many other things were. I have spoken with someone devout prior to ICU who is convinced they met God

[FamilyHistorian]

That’s an interesting question! Fortunately I can remember the detail of my hallucinations and with the exception of possibly 2 they connect to my reality. The trouble is that I can get confused between what is real and my icu reality. Never the less there are elements of truth in some of them. I’m not too sure what you mean by spiritual. I think you can identify coincidences. It is also very strange how some of them connect with one another.

[ComaResearcher]

Perhaps “ICU Delirium” is too broad a term. Should there be two terms? ICU Delirium might cover the experiences of patients in ICU who are obviously seriously unwell, heavily sedated and in and out of consciousness. But what of those who are in medically-induced comas? Should a different term apply? Coma survivors often report ultra-vivid nightmares, out of body experiences, meetings with deceased relatives, one-ness with the universe and alternative lives seemingly lasting decades while mere weeks or months pass in the outside world. The later looks like something else entirely. I would welcome your thoughts.

[FamilyHistorian in reply to ComaResearcher]

I was the same person through the decades but doing things appropriate to the respective time.

I was in different centuries in the location with technology that exists now (18 & 19 c).

I travelled the world under the control of a company intent on raising civil war.

My operations (to my body) were under water and my body parts were separated from one another whilst recovering.

I can go on but I looked quite good in a Georgian wig.

[Sepsur]

Ok - whilst in an induced coma - I lived multiple lives & my ‘dreams’ lasted decades - they were different to the semi-reality as I came out of an induced coma which was standard delirium

[Dabofoppo]

In my experience icu delirium is caused by the medication the effects of the illness on your body ( look at how urinary tract infections affect people especially women) and the strange environment you have nothing to ground yourself on because nothing is familiar. The spirituality bit is purely that person's belief I worked in wards and hospices for 10 years the people who report having spiritual experiences are believers in spiritual stuff.

In my personal and professional opinion the things you see and do before entering into a coma or icu affect what you see/ hear during delirium for me I seen polar bears snow and heard a lot of queen music the days leading up to my hospitalisation I had watched a Canadian TV show about lorries being recovered and seen bohemian rhapsody.

[Grant_za]

I have a slightly different take on things. Certain medications directly cause vivid dreams. One of which is an anti-malarial called Lariam. An anti-malarial is somewhat benign when standing side by side with products used in an ICU environment. I have no doubt the medication plays a role.Near death experiences are well documented by surgeons and critical care physicians across our planet.

Those reporting a NDE seem to go through a similar process, or experience.

The similar experience is common to people of differing religions (or no religion), cultures, race groups etc.

Clinically, death is recorded when there is no more cardiac or brain activity.

However, for death to occur at a deep cellular level, the process typically takes about 20 minutes after cardiac and brain function have ceased.

One of the unsolved mysteries is the seat of consciousness / awareness of self etc.

How does it come about, and where. Is it formed at a cellular level or somehow elsewhere.

Just like our scientific equipment can only go to a certain depth in the ocean, or distance into space, so too does our medical equipment have limitations.

For example, we are able to observe brain activity to a point, but that point does not extend to proper observation at a cellular level within the brain stem - for that, the brain has to be removed and dissected, which would be a defeatist exersize in itself.

Regards delirium, consensus seems to lean towards delirium being closer to hallucinations than dreams. Unlike dreams, hallucinations are very often brought on by some form of chemical - not always, but most often.

For the most part ICU delirium is much deeper and intense than dreams.

And unlike dreams, many who experience delirium, struggle to "recover" from the experience for a while after they have recovered from the actual condition that originally put them into ICU.

My thoughts are delirium is caused in part by the combination of medications that may in turn set off some form of chemical reaction at a deep level within the brain causing an increase in cellular / molecular activity. And conversely at the onset of death, the lack of oxygenated blood results in a differing chemical reaction during the onset cellular death, which is why those who report a NDE have a similar experience, despite the contrasts between their respective cultures and beliefs.

There may be parallels to drawn between those who experience delirium and those having a NDE.

Obviously, this "theory" of mine is nothing more than pure speculation on my part.

[stevet11753]

I find it difficult to truly identify which, if any, of my dreams occurred during induced coma; there was a long sequence, lasting (in the dream) for a couple of weeks with no interaction with the 'real' world. I came across an interesting book written by a neurosurgeon who was in a brain-dead coma due to a rare form bacterial meningitis: Proof of Heaven, by Dr Eben Alexander. The title tells you that he perceived what happened to him as a spiritual experience, despite his former scepticism about NDEs.

[Copse77]

I am interested to understand more about the research and who it is being conducted for. I am a scientist and have seen ICU delirium from a personal relatives perspective. It was very upsetting for me and traumatic to watch this. I do work for the Intensive Care Society Patients and Relatives Committee as well as helping on here where I can provide advice information and support. There was a very good Radio 4 History of Delusions series which covered ICU delirium. I posted links on here in the past to help relatives and patients.

[Jimmyclare]

I was in induced coma in November. After being woken up I suffered the delirium which is talked about. A lot of what I experienced was funny but some was scary. I was rushed into hospital after being ill for 3 days which I cannot remember. I had a covid test which was negative I had to be carried as I was so ill. As I was fit & have never been a smoker doctors took a while before diagnosing pneumococcal & cavitating pneumonia & sepsis twice. I had to start walking again before I could go home.

[Jimmyclare]

I was put in an induced coma in November. I was very ill for 3 days before I was rushed into hospital, I cannot remember those 3 days, I had a covid test which was negative, as I couldn't walk my husband carried me. Apparently I couldn't breathe so he rang 999. I was on 80% oxygen but deteriorated so was put in induced coma & transferred to Freeman hospital. After waking I have experienced delirium. I had a lot of thoughts some funny but some scary. I was convinced my daughter was a nurse looking after me. She isn't a nurse!!! I had to start walking again before I could go home

[Skyehammer]

I was put into an induced coma back in 2012 having contracted sepsis - my lungs and kidney failed at the local hospital then after a few days had passed and this time in Paisley [ where I was flown to ] my heart failed also - the Doctors told my wife to prepare the Family for my death so they didn't hold out too much hope .Cutting a long story short I survived but was in hospital for a total of 3 months .

My delirium was so realistic I was convinced I'd been held prisoner by this gang and raped - I told my Consultant about the experience and for a time he must have thought I was telling the truth as he told me to report it to the Police - it was only afterwards when another Doctor came to see me about it that I worked out from the timeline I could remember that all that couldn't have taken place .

There was nothing spiritual about my dreams , they were mostly terrifying .

The ' rape ' can be linked to the Nurses administrating a suppository and apparently I tried removing the breathing tube thinking they were giant worms going down my throat - all in all I was a bloody nuisance even in a coma and at one time I had to be held down by more than one Nurse .

In the dream I was also sectioned by my GP for biting into a film at a cinema [ yeah , strange I know ] - in real life I was biting into the breathing tube that was keeping me alive - so there is a connection to reality and memory - I was held prisoner in a building near water where two ferries sailed to and fro [ I worked on the Skye Ferries ] - I was rescued by an ex work colleague who then handed me over to this gang - apparently the voice of the Male Nurse in ICU sounded very similar to that of my old work colleague [ another connection to reality and memory ] .

I won't bore you with the rest of my dreams other than a few people from my past appeared in them [ all still living ] - while my dreams were mostly of the nightmare kind a Nurse who later looked after me told me that her Grandfather experienced a happy fever dream - he was a cowboy out riding the range .

I have read that Doctors are looking to treat people who have suffered from these nightmares similar to how they treat those suffering from PTSD .