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ICU Delirium Leads To Symptoms Of Dementia After Discharge


"Researchers are alarmed by what they are finding as they track patients for months or years after an ICU stay.

Patients, even young ones, can be weak for years.

Some have difficulty thinking and concentrating or have post-traumatic stress disorder and terrible memories of nightmares they had while heavily sedated.

Researchers are increasingly convinced that spending days, weeks or months on life support in the units can elicit unexpected, long-lasting effects." - Gina Kolata, January 11, 2009

Dr. O. Joseph Bienvenu, a psychiatrist at Johns Hopkins, worries about post-traumatic stress disorder.

While many remember nothing of their time in an ICU, others cannot forget horrifying hallucinations.

The experiences are all the more terrifying because patients cannot talk with mechanical ventilator tubes in their throats.

Their illnesses may produce delirium, but so may the drugs used in sedation.

"One man told me he saw children's faces that were blacked out and blood running down the walls," Dr. Bienvenu said. "He thought he'd been kidnapped and tortured. One woman said she saw her husband and a nurse talking, and she thought they were plotting to kill her."

Scientists are beginning to worry about the effects of simply being in an intensive care unit, on a mechanical ventilator that pushes oxygen under pressure in and out of the lungs, receiving doses of sedatives, narcotics and anesthetics high enough to make even healthy people stop breathing on their own (patients who are resting and sedated are also given less oxygen).

They have been particularly surprised by how quickly patients lost strength.

It looks like what was lost may not completely come back, even years later.

When Dr. John Kress, director of the medical ICU at the University of Chicago, began focusing on lasting effects of an intensive care unit stay, he wondered whether the sedatives keeping patients comfortable might actually be making them worse.

So his group tried an experiment, waking patients briefly every day by turning off their infusion of sedatives.

Patients actually did better and even had a significantly lower rate of post-traumatic stress disorder, which is manifested by such things as mood disorders, anxiety, difficulty concentrating, shortness of temper and frightening memories.







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