ICU “delirium”- what causes it? What does it mean ?

[strawberryjam]

My family member, age 30, spent 7 weeks in the hospital , much of it in ICU. He experienced vivid “dreams “, most of them very frightening , every time he went to sleep. Two of these dreams, one about being on a boat, the other about needing an antidote for a poison - would continue to develop on subsequent nights, like continuous frightening stories. Can someone explain this? I was unaware at the time but this seems to happen to some people. It got so bad that he tried not to sleep and when given sleep medication, the “ dreams” continued.

[Sepsur]

I had terrible icu delirium which lasted for a lifetime in my dreams but about 11 days for those at my bedside. When I woke after 57 days - I didn’t sleep for 3 days.

The delirium is thought to be caused by a combination of factors - a ‘perfect storm’

The sedatives and pain killers used on us are hallucinogenic.

The toxins in our body & blood from being that ill alter chemical balance of brain.

We often have renal failure - so the body cannot rid itself of toxins or sedatives which compound the chemical build up.

Being ill, not eating a balanced diet & the body striving to overcome the infections - our blood might lack the right mineral, viatamin, nutrient levels or be hydrated enough.

Sleep deprivation plays into it - we’ve had no reparatory REM sleep - we’ve just been made unconscious - imagine what a week longer bender would be like - how rested would you feel.

There is a delirium pdf on this link

cc-sn.org/information

[strawberryjam in reply to Sepsur]

Thank you for your detailed and informative answer. Yup, he had all of the above medical challenges. He has only been home for 3 weeks. I hope he can forget all of that trauma.

[Rhyl1 Partner Moderator ICUsteps in reply to strawberryjam]

Unfortunately these memories are often so traumatic that forgetting isn’t possible. Talking about the experience can help a lot and attending a support group can reassure someone that they are not alone in having such memories. Eye Movement Desensitisation and Reprocessing (EMDR) or cognitive behavioural therapy (CBT) are both good therapies to help reduce the impact of these memories. They can be a trigger for PTSD so coming to terms with these memories is important.

[Sepsur in reply to strawberryjam]

I’ve never forgotten BUT it doesn’t bother me anymore 😊. The dreams have been scorched into my consciousness

[HalfPint11 in reply to strawberryjam]

I went through all of this and at the time it was hard to make sense of it. Aswell as the dreams I had hallucinations and could "vividly" see nurses, doctors and even other patients who I now know didn't exist. A year on whilst I can still remember the dreams I feel much calmer about them and they don't disturb me like they did at the time. My family can laugh about them now because I imagined my children living very different lives than they do. My daughter drove a high powered motor bike and an HGV in a dream which just isn't her.

I think someone has already mentioned the Critical Care Support Network. They also do a drop in session via zoom for family members which you may find useful

cc-sn.org/drop-in-meetings

Take care

[qmcsurvivor in reply to Sepsur]

Really good concise answer; will look at web page you posted😃

[FamilyHistorian]

2 years on I can remember every detail of my hallucinations. BUT they don’t cause me any problems now. I had been in 2 hospitals for over 3 months just under 2 of those were in a coma. Water seems a common theme for some patients, it is said that this is because of the water beds we were on. My ambulance was a canal boat, I presume with a blue light 😂, I was operated on in in a swimming pool and a sailed on a boat in the 17th century. As far as I am concerned during my coma I lived in another reality and I am happy about that. At home 1 hallucination followed me and I had 2 new ones. I had problems with clock in the hospital which had multiple faces and told lies. When I came home my wife had bought a new toaster and the clock had transferred its powers which meant that when I went into the kitchen it watched me and followed me. This was very real. One afternoon I dropped off to sleep and couldn’t wake up because of all the machines around me. It wasn’t until they disappeared that I could wake up. And one night I woke to find my wife had a knife in bed!The other hallucinations were very complex and some were based on what I thought were real memories and they weren’t. Now it is difficult to workout what are real memories.

I had a course of CBT (11sessions) which for me was very helpful and gave me strategies for dealing with things.

[qmcsurvivor]

Hi, I did indeed have this and it was like our experience of everyday life but sadly a scary one that seemed never ending and definitely lasted for at least a week after coming off the ventilator, I can still remember the way it was so real.

All of mine was based in a hospital so I must have recollection of where I was but the memories were surreal, it is only after discharge that I looked back on them to try and work it out as some although comical looking back felt so true one example when on post ICU ward I heard two nurses talking with one saying to the other that she apologized for murdering 6 patients, the nurse she was talking to just replied laughing you will be OK tonight as the bay opposite has 6 beds; to me it was so real but as you can see when rationalised it couldn't have been true! This was one of the less extreme memories but it went on and on as though normal life,

I often also heard a noise that I thought was a monster but presume know it was machines used in ICU such as a suction machine. Over time the memory is still there but getting easier.

Best wishes.

[Offcut]

I had while I was in ICU 32 days. I called it my second life they were so vivid I was not sure what was reality or not? I was posting letters in cracks in my garden? And went to China and Korea in my head. When I was moved to another hospital still in induced coma, I had Chinese exchange nurses on the ward I was told later? To say they were Weird is an understatement. But strangely I can still remember them now 14 years on?