First of all just wanted to say thank you for everyone’s support and stories, they really are reassuring and nice to know that none of us are alone in this horrible time.
My Dad has been in ICU now for 35 days after having a cardiac arrest/stroke New Year’s Eve. We are in a position now where he has a trachy and is coping well with his breathing and heart/blood pressure seem to be stable. The doctors and nurses have over the last 10 days or so tried to reduce dad’s sedation however it seems that the barrier we face is his agitation. Some days he can be quite calm and settled when we visit; giving us a smile, responding to certain commands, mouthing words (some which we understand and some gibberish). On other days he can be very restless trying to get out of bed and being quite combative with members of staff resulting in the sedation to be turned back up. It’s been a cycle now of this for the past 10 days and feels never ending. Just wondered if this was a normal thing and if anyone had any experiences of this themselves ?
We would’ve been over the moon if someone would of said that we would be in this position a few weeks back as Dad has made positive steps forward we just need the agitation to be under control and for him to be calm to look at continuing to move forward.
Once again thank you so much for all your support.
Simon.
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sbiggs96
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Not had anything mentioned by anyone about this as of yet. We have some really good days where he is calm and can loosely follow some simple instructions, then the next day we will come in and he be fully sedated again. This is often because in the evening he can be quite restless and they will sedate him to keep him rested. Feels like we often make progress then take a few steps back. I know the agitation can be normal but just feels like and endless cycle at the moment.
Listen I’m not medical in anyway but your Dad sounds like he is experiencing delirium. This is really common 80% of ICU patients experience it. For some it is really disturbing, for a relative few, their delirium is pleasant or funny - some of us get a mixture of the two.
Delirium is caused by a cocktail of things - being that ill, sleep deprivation, mineral unbalances, dehydration and kidney dysfunction play their part. Many of the pain killers & sedatives are also hallucinogenic & cause awful nightmares.
The difference between a normal nightmare & one in ICU is that we cannot wake ourselves up so I scrolled through nightmare after nightmare without interruption.
It also got worse when they were trying to wake me because I experienced REM sleep again. Eventually it all lifted.
It is normal for many ICU patients. We all experience some form of delirium while waking up. Sepsur gave a great explanation as to why.
From personal experience, the nightmares during sedation can be a literal hell that seems more real than reality itself, and never seems to end.
Most ICU staff have no idea what we are dealing with. When I was waking up, my wife and nurses would try to talk to me, and when they bent over to hear me whisper a reply (can't speak with a trach), they looked giant. I thought they would smother me, so I tried to push them away with what little strength I had left. At some level, we also start realizing we aren't as we were before sedation - tubes, wires, lights, machines, and no strength to move. It is a lot to process and takes time.
When facing something so traumatic and life-threatening, I personally think our minds and bodies go into survival mode - fight or flight. Even after leaving the ICU some of us have found we lost our conversational filters, saying whatever came to mind without thinking; we would be easily frustrated and angered, etc.
I think most ICUs slowly reduce sedation so there is a balance between controlling agitation and giving the patient time to wake up. We can't remain sedated forever, and agitation isn't a matter of personality or behavior. It is a reaction to being in a living nightmare and trying to figure out what is real. Talk to him calmly. Show pictures of family or familiar things. Read to him - cards, letters, notes, etc. Don't let his agitation frighten or worry you - he needs to know you are real, and care.
My son has been in ICU since 21st December, admitted through A&E with severe pneumonia and flu, causing respiratory failure. He was placed on a ventilator. He had a tracheostomy after 10 days, and was weaned off the ventilator successfully. Problems arose when they tried to lift sedation, as he became locked in a hyperactive delirium and wasn't ever responsive. He constantly thrashed about the bed looking as if he was trying to get up, and they had to use soft restraints to prevent him dislodging the trachy tube or the lines. After several weeks of this and numerous scans and investigations looking for an underlying cause they decided to put him on a low level bed in a side room and withdraw all sedation. Preparatory to this they stopped all IV sedation, and almost immediately the hyperactive delirium calmed, he began to respond to his name and to follow simple commands. We have no doubt the sedative drugs were a major cause of the delirium, which was described as off the scale. Your father is responsive at least some of the time and the delirium will subside with time. It may be a long journey though
Thank you for this post. With my husband, I experienced not only agitation, but also aggressiveness. In August, he was in intensive care for ten days and received an ICD device. He doesn't remember anything, not even that he swore, but I understood a lot from his behavior now. Thanks. Of course, the situation has changed a lot since then, it has improved, but he still has aggressive manifestations from time to time. What worries me the most is that his short-term memory (and partly his long-term memory) has been lost. He has just undergone rehabilitation after bypass surgery.
Honestly my husband was like this for a month after having his trachy fitted. The ups and downs, not knowing what version you were going to find when we went to see him was so upsetting but it just takes time as they get fully weaned off the drugs. And I know a lot of people suffer with nightmares and flashbacks but my husband is not at all phased or traumatised by any of it and hasn't been since he fully came round. I struggle more than he does with everything that happened even though it's been nearly 2 years. Hang in there, the ICU staff know what they're doing and will slowly keep trying to bring him round, adjusting any sedation to suit. Your dad will get there x
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Dad in CVICU and not waking up completely from sedation. 
Husband in coma cardiac arrest, 20 min anoxic brain injuries. He’s opening eyes but staring at ceiling. No communication. 
Doctors giving little hope...
cardiac arrest oxygen hypoxia 
