Agitation will waking from sedation in ICU on vent and ecmo

[shivnajain]

Hi my uncle had a low oxygen stroke on 18 Dec and diagnosed with pnemonia and put on a vent machine and Ecmo on 20th Dec. He still has low recovery on lungs but he has not been able to come out of sedation. He is getting aggressive and agitated as soon as the sedatives are reduced. Its been 2 weeks now. Anyone faced a similar situation? How long can it take to come out of induced coma. Also doctors mentioned there could have been some brain damage from hypoxia, but they can’t do MRI right now. We are all super worried, any similar stories and cases will help give us some direction.

[Sepsur]

it took them 11 days to wean me as they reduced sedatives I experienced terrible delirium. They also feared a hypoxic brain injury which I might well have but it’s disguised/wrapped up in the plethora of unexplained ailments & conditions that I’ve had since ICU.

See PICS.

sccm.org/MyICUCare/THRIVE/P...

[Lux95]

It can take a while to wake up from sedation, and it varies from person to person. As Sepsur said, delirium affects a lot of us. I was never told if I was agitated, but apparently was restrained while they reduced sedation because agitation is common. The nightmares many of us experience while sedated seem to become our reality. So waking up can be a rough ride.

I think it was several days before I woke up, and it was disturbing experience. My wife and doctors who leaned in to talk to me and try to hear me (on trach, so I could barely whisper) looked huge and it both scared me and made me feel as if I was being smothered. But, family being there for him will make a big difference.

I don't know if there were concerns over hypoxia in my case, but my O2 level dropped to 30% at one point, and my heart rate also to 30 bpm, so I guess it is possible. Though many of us have some lingering side effects and changes, people around us often don't notice. It isn't something I would worry about at this stage.

Take it one day at a time. Surviving the ICU is a slow progress of small victories on a daily or weekly basis.

[IvyBonnie]

Does he still have a breathing tube in his mouth? That could be the cause? My partner tried having sedation reduced three times unsuccessfully but he couldn’t tolerate the tube down his throat. He had the tracheostomy and has had the sedation almost completely turned off now.

[shivnajain in reply to IvyBonnie]

No, he has a trachy. Also waiting to see improvements in the lungs. Hos lungs are about 80-90% involved.

[Copse77]

sorry to hear your Uncle has been so unwell. We went through a similar situation with my brother. I wrote our family story here to provide hope yo other families.

ecmofamilysupport.com/ecmo-...

[Copse77]

everyone is different in how they recover and respond. ECMO saved my brothers life when life support was not enough. ECMO allows the lungs to rest and recover though it takes time. My brother was a fit healthy non smoker when he became critically ill with sepsis from flu and we feel lucky he made a good recovery after receiving ECMO support. I hope the same for your uncle. There is a useful zoom call for relatives where you can speak to other families going through similar experiences. Please look at the ICU STEPs website guides on ICU recovery.

[shivnajain]

Also has anyone faces clotting issues with ECMO?

[Rdance in reply to shivnajain]

I believe it’s not uncommon but no personal experience.

[Copse77 in reply to shivnajain]

Yes they give drugs that can cause bleeds as part of the ECMO as I remember.

[ZanderB]

Hi shivnajain

I spent 3+ weeks in an induced coma with a tracheostomy and ECMO for some of that in late 2020. From what I've been told, agitation and aggression are quite common for those coming out of sedation. Apparently I was trying to pull tubes and wires out and had to be restrained by the nursing staff. Perhaps it coincided with the vivid delirium I experienced - maybe the one where a doctor and nurse kidnapped me to harvest my body parts whilst I was paralysed?

Do read the links suggested above. I did not know that ICUsteps or other organisations existed until about 2 years after I left intensive care. I think it would have made my life much easier if I had. And look after yourself too! It's easy to under-estimate the impact on family and friends.

[shivnajain in reply to ZanderB]

thankyou

[BilliyR]

hi it took me 2 weeks to come out of induced coma after medication was reduced! Agitation is quite normal! Good luck with his scans, hope all goes well!

[BigH63]

Hi

As everyone has said and I concur. It apparently to me a long time to come around and yes delirium is a problem, I also had suspected brain damage and as Sepsur say I think I still have some, they took me to have a MRI while still sedated because I was not responding.

So take some heart that all what you are witnessing is very common in ICU patients, I hope things improve for him and you.

Just keep doing what you’re doing, being there

Good luck

[Misterpaulwood]

Can take weeks, after 8 weeks in a induced coma, I was delirious for 3 weeks...It passes.....

[Tanyacase78]

thanks for your post because yours and others are helping me too. My dad went into icu on 18th December. Had the breathing tube down his throat then he couldn’t tolerate that as his heart was doing crazy things so he had a tracky fitted also. That was about 2 weeks ago and he is now being weaned off of it for two hours 4x a day however he has bad delirium which is so stressful for mum and I. We go in every day and what a rollercoaster of emotions it is. Like you I have come on her for answers and comfort and it’s helped a lot. You feel like you’re the only one in this situation so although its obviously awful and sad others suffer the same it’s also a help to us loved ones that it isn’t just us going through it.

My dad is a very calm well mannered man and would hardly ever swear and especially not in front of a lady. However he has been swearing so much. He almost goes in and out of being able to understand us to going into angry states and not making sense. I’ve been called in by the nurse and he has being saying he would be dead which really upset me. He is also very private and I think one of the biggest things for him that’s stressing him out is having a colostomy bag. He keeps thinking he needs to go toilet and asks us to leave. Then he wants the nurse to take him but he can’t get out of bed at the moment as he doesn’t have any strength. They have told us it will take a while and it’s a slow process so we are taking it day by day.

One thing though it puts things into perspective in life and the little things become a massive appreciation for us all.

I’ve never taken my parents for granted as I’m an only child and have always worried immensely about them so this has hit me hard but my god that’s tripled for me now !!

Lots of luck to you all going through this same experience. It’s great to support each other. Just remember day by day xx