My 71 yr old dad suffered a cardiac arrest 2 weeks ago. He was placed on a ventilator and sedated. He was on sedation for 3 almost 4 days. He was taken off sedation and has not woken up enough to follow commands enough to have the ventilator removed. He is only on 21% of oxygen and pressure support. His vitals are stable and his two MRIs and EEG scans show no anoxic brain injury, seizures or signs of stroke. My dad does grimace at pain, moves his head back and forth, opens eyes and wiggles toes. Meeting with pallative care to discuss next steps of getting a trach and feed tube inserted. Cardiology has signed off his case until his is following commands and has a good neuro diagnoses. Has anyone experienced this before? Please share your experience ...
Dad in CVICU and not waking up completely from se... - ICUsteps
Dad in CVICU and not waking up completely from sedation.
it took me some time to wake after sedation, in my case nearly 11 days. I did pretty what your father is doing, grimacing, opening and closing eyes, wiggling toes etc etc…the waking process is different with all of us and can be exaggerated if you are on dialysis for instance. In my case, the trachy was the best way forward.
I don’t remember the reality of this period at all but I do remember becoming aware of being in hospital and having nurses fussing around at some point.
I had come out of a period where I had the most vivid dreams and hallucinations commonly called ICU delirium.
Thanks. I continue to wonder how conscience he is right now. Everyone says he can hear us. He moves his head towards you when speaking to him, gets very active when speaking to his grandkids on Facetime, even bits the ventilator tube. He however sleeps a lot day and night. I can't wait til he is fully back with us and talking.
I was very responsive to voices - can you imagine what happened when no one was allowed into the ICU & we ( as patients) had nothing familiar😳😳😳😬😬
similar to Sepsur 3 years ago I was coming out of my coma after 2 months. I’m 75 in a couple of weeks. Apart from pneumonia & sepsis I also had open heart surgery. It took a long time for me to be weened off the drugs. I had a trachy because I didn’t tolerate intubation and I had a feeding tube.
Did you go to a Long term acute hospital? Did the doctors tell your family they don't know why you weren't waking up? We are at the place where they scientifically can tell us why he hasn't woke up. They don't know what his prognosis will be. They haven't addressed his heart.
to start with I went to a local hospital following heart issue and then I got pneumonia. They sent me home! Within a couple of days I was back in with sepsis as well. I needed a valve replacement and was transferred to an acute hospital where within a day I was transferred to ICU and put in a coma. Technically I was too ill to be operated on. In then end they did. Initially they say I would be brought round within a couple of days, that changed to a week, then a couple with them finally saying he will come round when he is ready (nearly 2 months later). My family were also called in twice as I wasn’t expected to make it. Having since read my notes I’m not surprised as my Glasgow scale was really low ie dead.
I have changed, for a start I lost 3 months memory from before going into icu. Of course I can’t remember the coma although I can recall every detail of my delirium / hallucinations which is when I lived in another reality. I had to re learn to talk, eat, walk etc. I have always had a wicked sense of humour but it’s now evil. My brain doesn’t control my mouth, I try very hard not to offend any one but if I do it’s their problem not mine.
I’m one of those patients that wasn’t aware of visitors or other people’s voices.
I will never understand the trauma that you are going through but my advice is that you really need to look after yourself at this time.
My dad was the same 11 days under sedation and another 9 days or so not responding to the nurses requests, bad agitation when coming off of sedation they they had to put him back under. EEG also showed no hypoxic brain damage, but u can't really tell until they fully wake I was told by nurses but all those scans checking and they can see no seizures is all good signs. We spent another 2 weeks or so in cardiology and my dad still wasn't right not speaking to us ( as he couldnt really speak) and not recognising who me or my mum were. A feeding tube was inserted and he was nill by mouth. Eventually he brightened up a bit and mentioned my name but was still very delusional. He went to rehab was very agitated but at least could walk. Fast forward 4 months he was home and continues to progress he can do most things now him self again, dressing is difficult as his perception is off and a few difficulties with day to day tasks but nothing major. Lacks motivation to do stuff. We are now 6 months since his cardiac arrest and he continues to progress, memory Is good, his humour is normal.There was plenty to say about this but I've tried to keep it as short as possible and give u the key points. Be prepared for a different dad he may not be able to do what he used to and may become tired very quickly.
I wish u all the best and for ur dad to make a speedy recovery.
Emma.
Aww thanks for sharing. This gives me hope. I know all people are different. I think the hard part is none of the doctors share this with the families. It so cut and dry with them and they don't provide a lot of hope. I don't care if there is slowing down or a different guy, I just need him back.
Yh the doctors want want to say anything because they can never tell and wouldn't want to get ur hopes up or vice versa, its a long haul to recover everyone kept telling me it takes time and to have patience, they were very correct. I understand ur circumstances though its so difficult when u don't know what will happen. Just have faith every thing will be fine and take every day as it comes.
I have my fingers crossed for u and speedy recovery for ur dad.
Emma.
That’s really good that oxygen support is so low. Like everyone else said, the wake-up process takes time / weaning off sedation is very tricky. My husband is much younger and struggled to wake up after 2-3 days of sedation. They ended up tweaking his drugs to wean him off better after which he did wake up but with bad ICU delirium. He ended up getting put back under for another 2 days then weaned off again with an additional one-shot dose of a benzo.
Just make sure they keep trying to wake him up every day and maybe do question their approach for waking him up to be sure that they are on top of it and have a plan B.
I have no personal experience with trachy or any healthcare experience but I would wonder why they are choosing to do a trachy instead of tweaking the wean first. A trachy seems like they are in for a long time to waking him up — I know their goal is to get him off the ventilator asap but why don’t they try tweaking sedation first?
oh I’m sorry, I missed it jn your post that your dad is already off sedation
Hey sorry I wrote a reply to your post the other day and with the internet connection at the hospital is never posted. Thanks for your post. I appreciate the info on waking him up everyday and having a plan B.
My fit and healthy wife (70) suffered acute life threatening ashama and is now a week on intubation in ICU.They won't take her off it until she responds to commands and stopping fighting the tubes when semi conscious.
This is very disturbing as her vitals are all good
Just be patient and allow her body to heal itself. I know the clinical staff can be very strong about what they consider follow commands but you are with your wife/family member more than they are and if you see improvements from day to day celebrate that growth. I know I got tired of them saying my dads situation was basically hopeless but he was doing more and more each day and we noticed his progression from when he first got to the hospital. Im still very scared and he has a long road ahead of him but Im so happy for were we are now.
has anyone mentionedICU delirium to you?
Yes. And have read up on it, thanksConsultant didn't mention it though.
Update.... My dad got off the ventilator after 14 days. He has slowly begun to come around and be more alert. He has only used about 3/4 words and response to commands and painful stimuli. He still is very fatigued. He is currently breathing room air (no oxygen needed) and has moved out of ICU! I'm so scared cause I'm use to him having all the bells and whistles (monitors) of ICU and this floor has none of that. Boy what a difference a day makes. On Tuesday I was planning for a trach, peg and long term care hospital for him and now we don't need either of those.
Having read the original post and the great comments of the past week I am utterly delighted to see this! My mum had virtually total organ failure exactly a year ago and was intubated on the day Putin started this wretched war (least said!) Only her heart was strong and she was on the vent for 9 days. We were so fortunate to be in Stoke Mandeville which is my parents local hospital anyway so the Icu and Hdu staff were so experienced. We were told by our favourite nurse to anticipate 1 week for each day on the vent before there was any need to worry about my mum even though she was already 80+ which always makes recovery tougher. And he was about right before I could see the old mum personality wise. So this is a marathon not a sprint and getting off ICU (while scary I agree 100%) is the end of the beginning as Winston Churchill said. Mum came out of hospital last Easter so a good 5 weeks after waking up but was signed off by the consultant in August and is now back literally to her old self and over in Aus spending 6 weeks with my brother!!I agree the delirium was challenging. At least twice we considered taking her mobile phone away as she made some troubling calls to friends and family(1 who wasn't even aware of what had happened) saying she'd been kidnapped 🙄And now? Her brain has blocked the entire experience out, bless her.
Stay strong and if the staff will entertain the idea try to get your Dad's entire bed pushed outside when the sun is out. Stoke Mandeville swear by that, fresh air and regularly telling their patients the time. It helps to reconnect them with the world around them. Stimulate the other senses with music , fragrances eg spring flowers to smell, touch - take hand cream in. It all helped my mum xx
My dad went into ICU & on to a vent as a result of septic shock. He didn’t come off the vent until 6 weeks later. My dad had a trach placed b/c he wasn’t responding well & was having significant trouble weaning off the vent.
This all happened during COVID so visitors weren’t allowed at the hospital. B/c of the amount of time my dad had been in, after the 5th week, the hospital let 1 visitor in for 1 hour each week. After my second week visit, the doctors started talking to me about “palliative care” and considering the possibility that he’d never come off or wake up again. They told me that medically they’ve done everything they could for him and he had started to develop several infections (including double pneumonia from an antibiotic-resistant bacteria). The prognosis was grim. Literally 4 days after that conversation, my dad was awake.
They were able to reduce the sedation enough over 2 days and he was finally awake (semi-awake?) by the 4th day.
My dad was 60 at the time but I must say, it sounds like your dad is doing better than my dad did. My dad had so many things going against him but he came back. His doctors, his nurses, even our family were beyond shocked at the quick & unexpected turn around. I pray the same thing happens for your dad & your family.
This all happened a little over 2 years ago. My dad is basically back to his old self. He’s a little slower than he used to be, a little more tired. I don’t know how much of that is related to the illness or just him being a little dramatic lol. But he’s here. Alive & well.
Hoping you have the same (or better!) experience. There’s a lot I didn’t mention here but if you have any questions I’ll be happy to answer if I can!
Regarding your dad's being a little slower and more tired 2 years out, I now think that is common. Whether we are being overly dramatic about it, I don't really know. I've wondered that myself.
It's been a year for me, and I don't think I'll ever be 100%. My memory and dealing with stress were effected. I forget basic words and common memories from time to time. I tried to type "whisper" earlier tonight and kept typing "whispier". I have to be careful to not take on too many tasks or overly stressful situations or I get frustrated, can't think clearly and have to walk away. I used to pride myself in being able to multitask, and think through multiple problems at once, and compartmentalize stress. Now it seems I can't.
I used to run, ski, and go on 6-8 mile hikes and could get back in shape in a couple of weeks if I missed a month or two. Not anymore. It's taken a year just to regain a baseline of strength and lung stamina for everyday life and work, though I am not nearly as disciplined about exercising as I should be. I just don't seem to make much progress most of the time and that doesn't help. It's just harder to recover from being physically reset to near zero functionality. It is mentally difficult to overcome the fear of a repeat. I can tell I "play it safe" now. I spent the first 10 months thinking I was fine and could get back to normal as long as I could walk into an office and get to work. I was wrong. It was a mistake. Everyone is different, but it seems common that it can take years to recover, and we may or may not ever really be the same as we were before illness. But you are exactly right - being alive and well is enough!
I know its very worrying when a person is under sedation as its hard to communicate with them . I found even just being there and holding their hand really helps . My relative was heavily sedated for a while too. It took them a while to come out of sedation and to become more responsive . now they are at the point where they are talking thankfully .I wish your dad a good recovery.
it took me 3 weeks to wake up. Don’t give up hope.
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